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Distal Pancreatectomy with Celiac Axis Resection Including Multivisceral Resection after Embolization with an Amplatzer® Device

José M Ramia, Roberto De la Plaza, Julián Del Cerro, Raquel Latorre, Alba Manuel-Vázquez, A Lopez-Marcano, N Mimicz

Distal pancreatectomy with celiac axis resection, also known as Appleby's modified operation, is a surgical technique used for locally advanced pancreas tumors. As the number of cases performed in western countries is small, its indications, technical aspects, therapeutic strategy and oncological utility have not been widely defined. Preoperative hepatic artery embolization has become popular as a method to reduce postoperative ischemic complications, but it is not systematically performed. Multi-visceral resections due to tumor invasion of neighboring organs are carried out in up to 20% of patients. Here we describe a patient with an advanced pancreatic tumor who underwent a distal pancreatectomy with celiac axis resection with multi-visceral resection in combination with Preoperative hepatic artery embolization.