A 73 year old woman presented with a pancreatic tumour invading the portal vein and common hepatic and splenic arteries (red mass, panel A) without signs of metastasis. Subtotal pancreatic resection together with resection of the portal vein and common hepatic and splenic arteries was performed.
The gastroduodenal artery (white line) was used to replace the common hepatic artery. Its distal end was ligated and anastomosed onto the coeliac trunk (white arrow shows the location of the anastomosis).
Two months later a follow-up computed tomography angiogram (panel B) revealed normal liver perfusion and a patent anastomosis.