OBJECTIVE: To introduce our experience with modified Appleby operation in the treatment of a patient with advanced carcinoma of the body and tail of the pancreas, which invaded the common hepatic, splenic and celiac arteries.
METHODS: The celiac artery was ligated at its start point, and distal pancreas and involved arteries were resected en bloc. Pyloric and right gastroepiploic arteries should be preserved to keep blood supply to the stomach and pulsation of the proper hepatic artery be felt after occlusion of the common hepatic artery.
RESULTS: The patient was free from epigastric and back pain after the operation, although she died of liver metastasis after seven months. CT scan did not show local reccurrence before her death.
CONCLUSION: This procedure can increase the resectability and radical extent of locally advanced cancer of the body and tail of the pancreas and offer patients a better quality of life.