Pancreaticoduodenectomy for biliary tract carcinoma with situs inversus totalis: difficulties and technical notes based on two cases

World Journal of Surgical Oncology

Koichi Hirata¹  Toru Mizuguchi¹  Masaki Kawamoto¹  Makoto Meguro¹  Masayuki Ishii¹  Motonobu Uchiyama¹  Masafumi Imamura¹  Yasutoshi Kimura¹  Daisuke Kyuno¹ 

[1] Departments of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, 1-South, 16-West, Chuo-ku, Sapporo 060-8543, Japan

关键词: Situs inversus totalis;    Pancreaticoduodenectomy;    Hepatobiliary malformation;    Cardiovascular malformation;    Biliary tract carcinoma;   

Others  :  820715
DOI  :  10.1186/1477-7819-11-312

 received in 2013-10-17, accepted in 2013-12-07,  发布年份 2013

【 摘 要 】

Situs inversus totalis (SIT) denotes complete right-left inversion of the thoracic and abdominal viscera. Diagnosis and surgical procedures for abdominal pathology in patients with SIT are technically more complicated because of mirror-image transposition of the visceral organs. Moreover, SIT is commonly associated with cardiovascular and hepatobiliary malformations, which make hepatobiliary-pancreatic surgery difficult. Two cases of pancreaticoduodenectomy for biliary tract carcinoma in patients with SIT are presented. Both patients had an anomaly of the hepatic artery. Advanced diagnostic imaging techniques were very important for careful preoperative planning and to prevent misunderstanding of the arrangement of the abdominal viscera. This facilitated the surgical team’s adaptation to the mirror image of the standard procedure and helped avoid intraoperative complications due to cardiovascular and hepatobiliary malformations associated with SIT. Pancreaticoduodenectomy in patients with SIT can be performed successfully with detailed preoperative assessment, use of effective techniques by the surgeon, and appropriate support by assistants.

【 授权许可】

   
2013 Kyuno et al.; licensee BioMed Central Ltd.

【 图 表 】

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