Abstract
A 72-year-old man diagnosed as having pancreatic head cancer was referred to our hospital with obstructive jaundice. An abdominal CT showed an anomalous common hepatic artery branching off from the superior mesenteric artery and penetrating the pancreatic parenchyma behind the portal vein, namely, a hepatomesenteric trunk. After neoadjuvant chemotherapy with gemcitabine and S-1, pancreaticoduodenectomy was performed with concomitant resection and reconstruction of the hepatic artery using the mobilized splenic artery. Histopathological examination revealed invasive ductal adenocarcinoma (mod to por) of the pancreatic head, pT3, pN0, pM0, pStage III, R0. The tumor was closely attached to the anomalous hepatic artery without the histopathological evidence of involvement of the vessel. Contrast-enhanced abdominal CT carried out 6 months after the surgery showed patency of the anastomosed hepatic artery.
