The role of preoperative embolization of the common hepatic artery in patients with tumors of the body and tail of the pancreas with invasion of the celiac trunk

The aim of the study was to determine the indications and evaluate the safety and effectiveness of preoperative embolization of the common hepatic artery in patients with the tumors of the pancreatic body and tail with celiac trunk invasion.

Materials and methods: Distal subtotal resection of the pancreas with resection of the celiac trunk and the common hepatic artery was performed in 32 patients. Of these, 8 had preoperative embolization of the common hepatic artery. The indication was the lack of adequate collateral blood flow through the pancreaticoduodenal arcades.

Results: Complete block of the common hepatic artery blood flow was achieved in all 8 patients who underwent preoperative embolization of the common hepatic artery, despite invasion of the celiac trunk. There were no com­plications during X-ray-guided endovascular intervention. A follow-up upper mesenteric angiography demonstrated adequate blood supply to the liver in all patients due to the development of collateral blood flow from the superior mesenteric artery territory. No ischemic complications in the liver were observed in the postoperative period, however, one patient had clinical manifestations of acute cholecystitis, which was relieved by conservative therapy.

Conclusions: Preoperative embolization of the common hepatic artery is a technically feasible and safe procedure that reduces the risk of ischemic complications in patients who have undergone distal subtotal resection of the pancreas with resection of the celiac trunk and common hepatic artery without angioplasty.

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