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- W2654707966 abstract "症例は60歳代，男性．主膵管拡張とCA19-9高値を指摘され，精査目的に当院紹介となった．ERPにて主膵管は膵頭部で途絶する所見を認め，膵管ブラシ擦過細胞診により腺癌の診断を得た．腹部造影CTにて血管解剖を観察したところ，hepatomesenteric typeの総肝動脈分岐変異が存在し，さらに上腸間膜動脈起始部に閉塞が認められ，血管造影検査や3次元画像解析にて精査を行った上で亜全胃温存膵頭十二指腸切除術を施行した．肝血流および上腸間膜動脈末梢領域の血流確保のため，可能な限り側副血行路を温存することで血行再建の必要なく安全に手術可能であった．上腸間膜動脈の狭窄や閉塞を伴った膵頭部腫瘍の切除例は散見されるが，本症例ではhepatomesenteric typeの総肝動脈分岐変異を伴っていたことから，切除に際して肝血流確保も考慮した十分な血行動態の把握と慎重な手術操作が必要と考えられた．" @default.
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- W2654707966 date "2015-01-01" @default.
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- W2654707966 title "A case of resected pancreatic head cancer associated with hepatomesenteric type hepatic artery variation and superior mesenteric artery occlusion" @default.
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