Staged Celiac Artery Resection with Pancreatosplenectomy (SCARPS) - A Novel Approach to Pancreatic Cancer Encasing Celiac Axis Trunk Robotically

Abstract To avoid hepatobiliary and gastric ischaemia related directly to Appleby Kondo’s procedures, a novel SCARPS procedure (Staged Celiac Artery Resection with PancreatoSplenectomy) for resection of pancreatic cancer involving celiac axis trunk is described here. A 67-year-old female biopsy proven Pancreatic Ductal Adenocarcinoma (PDAC) encasing common hepatic artery underwent two stage robotic operation Da Vinci Xi following 12 cycles neoadjuvant FOLFIRINOX 45 Gy chemoradiation. Stage 1 consisted diagnostic laparoscopy ligation Common Hepatic (CHA) after trial vascular clamping real time assessment flow using laparoscopic / intraoperative doppler ultrasound 2 CHA pancreatosplenectomy weeks repeat CT abdomen/pancreas. Both procedures were performed robotically. Resistive Index (HARI) increased 0.8 preserved forward flows. The operative was 80 min 240 respectively minimal blood loss without perioperative transfusion. offers safe an disease status real-time haemodynamic study prior major resection. Furthermore, it fervently as minimally invasive approach involvement benefit patients quick recovery.