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Celiac artery occlusive disease: a rare but potentially critical condition in patients undergoing pancreaticoduodenectomy

Authors :
Mehdi, Ouassi
Mehdi, Ouaissi
Robert, Verhelst
Parla, Astarci
Parla, Astraci
Gébrine, El Khoury
Catherine, Hubert
Bernard E, van Beers
Bernard, E van Beers
Laurence, Annet
Pierre, Goffette
Philippe, Noirhomme
Jean-François, Gigot
UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire
UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique
UCL - (SLuc) Centre de malformations vasculaires congénitales
UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation
UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale
UCL - (SLuc) Service de radiologie
UCL - (SLuc) Centre du cancer
UCL - SSS/IONS/NEUR - Clinical Neuroscience
Source :
Hepato-Gastroenterology : current medical and surgical trends, Vol. 58, no. 109, p. 1377-1383 (2011)
Publication Year :
2011

Abstract

Undiagnosed occlusive disease of celiac trunk and/or superior mesenteric artery may lead to life-threatening complications after pancreatoduodenectomy.Retrospective analysis of a consecutive series of 171 patients scheduled for pancreatico- duodenectomy or total pancreatectomy.The prevalence of arterial occlusive disease was 5.9% (10 patients), including complete celiac artery occlusive disease in 2 patients (1.2%). Preoperative diagnosis was achieved in 90% of the patients by lateral-views of imaging studies. In arterial stenosis50% (3 patients), abstention was always successful. In arterial stenosis50%, successful treatment options included abstention (n=1), preoperative endovascular dilatation (n=1) or stenting (n=1), division of the median arcuate ligament with (n=1) or without (n=1) postoperative endovascular stenting, and aorto-hepatic bypass (2 patients). No early postoperative ischemic complications occurred. However, one patient died from late intestinal ischemia.Arterial occlusive disease is rare in patients undergoing pancreatico-duodenectomy but expose the patient to severe complications if undiagnosed. A tailored management according to the type of arterial stenosis, to patients' indication for surgery and to patients' arterial anatomy is indicated. Surgical and endovascular management may be successfully combined.

Details

ISSN :
01726390
Volume :
58
Issue :
109
Database :
OpenAIRE
Journal :
Hepato-gastroenterology
Accession number :
edsair.doi.dedup.....9163eeb6bc2f542da86046b69c17706c