Extensive multiarterial resection attending total duodenopancreatectomy and adrenalectomy for MEN-1-associated neuroendocrine carcinomas

Figure 6 View of operating field after total duodenopancreatectomy and splenectomy with superior mesenteric artery, left hepatic artery and right hepatic resection, excision of common hepatic artery and proper hepatic artery and completion of vascular reconstruction prior to right adrenalectomy. Superior mesenteric artery (SMA) sutured to the root of resected hepatomesenteric trunk (SMA anastomosis). Splenic artery (SA) resected, U-turned and sutured to newly remade left hepatic artery (LHA) and right hepatic (RHA) junction (splenobihepaticoanastomosis). LGA: Left gastric artery; SMV: Superior mesenteric vein; PV: Portal vein; RDA: Right (inferior) diaphragmatic artery.