Journal of Gastroenterology Research and Liver Diseases

Three-dimensional reconstruction simulation assisted pancreaticoduodenectomy forpancreatic head carcinoma in a patient with situs inversus totalis: Report of a rare case 

Peng Du, Xingjian Zhang, Yong Li

Situs inversus totalis (SIT) is a rare congenital malformation that refers to a complete reversal of the thoracic and abdominal viscera. An extremely small number of SIT patients with pancreatic head cancer have been reported. Surgical procedures in patients with SIT are more complicated and technically difficult due to the rearrangement of anatomical structures. Adequate and meticulous preoperative assessment of tumor regional anatomy, potential cardiovascular anomalies, and aberrant blood vessels by imaging examinations is critical for facilitating the safe and effective performance of the surgery. The current study reports the case of a 69-year-old female with pancreatic head cancer and SIT, and first focuses on the application of 3D reconstruction simulation assisted pancreaticoduodenectomy (PD) in patients with SIT. Based on the data of CT images, we reconstructed a real-time 3D simulation model with Myrian XP to assist with our surgical planning. Then, we performed smoothly PD with complete resection of the tumor. The patient was discharged without any serious complications. Follow-up has been 2 years and the patient is doing well with no recurrences.