A CASE OF APPLEBY'S OPERATION WITH RECONSTRUCTION OF HEPATIC ARTERY FOR ADVANCED GASTRIC CARCINOMA

Abstract

This paper describes a case of Appleby's operation with reconstruction of hepatic artery by saphenous vein grafting for an advanced gastric carcinoma. A 74-year-old man had an advanced gastric carcinoma with direct invasion to the lateral segment of the liver and transverse mesocolon. Total gastrectomy, distal pancreatectomy, splenectomy, choleiystectomy, lateral segmentectomy of the liver, and partial resection of the transverse colon were performed. Since the common hepatic artery was entangled by the metastatic lymph nodes, the celiac artery was excised at its root and the proper hepatic artery and gastroduodenal artery were divided. To avoid ischemic liver damage, the hepatic artery was reconstructed using a saphenous vein graft. Postoperative liver function was satisfactorily maintained.