MODIFIED APPLEBY PROCEDURE FOR LOCALLY ADVANCED PANCREATIC CANCER (LAPC) AFTER NEOADJUVANT THERAPY
Kuirong Jiang*, Jie Yin
Pancrea Center of The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
We present a video of a patient with locally advanced pancreatic cancer who underwent a modified Appleby procedure for tumor clearance following neoadjuvant chemotherapy. Technical aspects include Kocher's maneuver to mobilize the head of pancreas, dissect SMV with tumor involvement, extended lymph nodes clearance for hepatoduodenal ligament, sub-adventitial dissection for CHA and GDA, resection of Gerota's fascia and reconstruction of PV-SMV. With proper patient selection and preparation, LAPC with celiac axis involvement following neoadjuvant chemotherapy can be safely resected with favorable outcomes.
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