10 September 2022
: Case report 
A 47-Year-Old Man with Advanced Distal Pancreatic Carcinoma and an Initial Partial Response to Chemotherapy Requiring Celiac Axis Reconstruction of the Common Hepatic Artery and Left Gastric Artery
Unusual or unexpected effect of treatment
Ayano Sakai1E, Takamichi Igarashi1E, Isaku Yoshioka1E, Kazuto Shibuya1E, Nana Kimura1E, Yuuko Tohmatsu1E, Toru Watanabe1E, Katsuhisa Hirano1E, Haruyoshi Tanaka
1E, Satoshi Onoda2E, Noriko Okuno3E, Takeru Hamashima3E, Johji Imura4E, Toshihiko Satake 2E, Tsutomu Fujii 1E*
DOI: 10.12659/AJCR.936840
Am J Case Rep 2022; 23:e936840
Figure 2. (A) Intraoperative findings before the tumor removal. The tumor had invaded the celiac artery (CA), common hepatic artery (CHA), left gastric artery (LGA), and splenic artery (SPA). (B) Intraoperative findings after the tumor removal and vascular dissection. (C) Intraoperative findings. We anastomosed the superior mesenteric artery (SMA) to the CHA using the middle colic artery (MCA) and anastomosed the second jejunal artery (J2A) to the LGA. The black arrowhead indicates CHA-MCA anastomosis, and the black arrow indicates LGA-J2A anastomosis.