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Resection of pancreatic head neoplasm in a patient with previous coronary bypass grafting using right gastroepiploic artery

A 64-year-old man was admitted for assessment and management of pancreatic head tumour. He had a history of angina pectoris which was treated by coronary artery bypass grafting (CABG) using the pedicled right gastroepiploic artery (RGEA) 7 years ago. His follow-up CT scan revealed a 4 cm-sized multilocular cystic tumour of the pancreatic head, which was gradually enlarging during 2 years and was suggestive of potentially malignant intraductal papillary mucinous tumour (IPMN), without evidence of distant metastasis (figure 1A, B). Coronary CT showed the patent RGEA graft connected to the right coronary artery (RCA) (figure 1C, video A). After discussing how best to manage intraoperative coronary vascular flow by surgeons, cardiovascular surgeons …