# Successful treatment for pseudoaneurysm following distal pancreatectomy with celiac axis resection without postoperative pancreatic fistula: a case report

## TL;DR

A patient with pancreatic cancer successfully underwent a complex surgery and later had a treated pseudoaneurysm without major complications.

## Contribution

This case report highlights successful management of a pseudoaneurysm following a complex pancreatic surgery without postoperative pancreatic fistula.

## Key findings

- A patient had successful treatment of a pseudoaneurysm detected 10 months after surgery.
- No postoperative pancreatic fistula occurred despite the complex procedure.
- The patient remained free of tumor recurrence and pseudoaneurysm relapse for 2 years.

## Abstract

Distal pancreatectomy with celiac axis resection (DP–CAR) represents an innovative surgical approach for locally advanced pancreatic body cancer in cases involving celiac axis invasion. However, this procedure carries significant perioperative risks, including arterial aneurysms and organ ischemia. Understanding these risks is crucial for optimizing patient outcomes and guiding treatment decisions.

This case report describes a unique case of a 74-year-old male patient who was diagnosed with locally advanced pancreatic body cancer with invasion of the celiac and splenic arteries. He underwent DP–CAR after six cycles of chemotherapy. His postoperative course was uneventful without any evidence of postoperative pancreatic fistula. However, at the 10-month postoperative follow-up, pseudoaneurysm was incidentally detected in the anterior superior pancreaticoduodenal artery by follow-up computed tomography. It was successfully treated with coil embolization. He had no signs of tumor recurrence or relapse of pseudoaneurysm formation 2 years postoperatively. This case report discusses the potential risks of pseudoaneurysm formation in patients undergoing DP–CAR due to hemodynamic changes. We emphasize the significance of close monitoring in such cases.

The case highlights the importance of recognizing and managing potential complications associated with DP–CAR in patients with pancreatic cancer. Despite its effectiveness in achieving complete resection, DP–CAR carries inherent risks, including the development of pseudoaneurysms. Vigilant surveillance and prompt intervention are crucial for optimizing patient outcomes and minimizing postoperative complications.