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. 2006 Sep;192(3):330-5.
doi: 10.1016/j.amjsurg.2006.05.010.

Extended pancreatectomy with resection of the celiac axis: the modified Appleby operation

Singh Gagandeep  1 , Avo Artinyan, Nicolas Jabbour, Rodrigo Mateo, Lea Matsuoka, Linda Sher, Yuri Genyk, Rick Selby
Affiliations

Extended pancreatectomy with resection of the celiac axis: the modified Appleby operation

Singh Gagandeep et al. Am J Surg. 2006 Sep.

Abstract

Background: Celiac axis invasion by central and distal pancreatic cancers has been considered a contraindication to resection. Appleby first described en-bloc celiac axis resection with total gastrectomy for locally advanced gastric cancer. We present our experience with a modification of this procedure in central pancreatic cancers involving the celiac trunk.

Methods: Three patients with central pancreatic cancers invading the celiac axis are reviewed. All patients underwent extended pancreatectomy with en-bloc resection of the celiac axis.

Results: Margins were grossly clear of tumor in all patients. The mean length of stay was 8.3+/-1.1 days. There was no evidence of clinically significant gastric or hepatic ischemia. All 3 patients remain disease free at 34, 14, and 14 months from surgery, respectively.

Comments: Extended pancreatectomy with celiac axis resection can result in prolonged survival and should be considered in central and distal pancreatic cancers invading the celiac trunk.

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