• 作者：José ; Muros^a ; Jordi Soriano^b ; Antonio Codina-Barreras^c ; Pere Planellas^c ; Santiago Lopez-Ben^c ; Maite Albiol^c ; Laia Falgueras^c ; Ernesto Castro^c ; Anna Pigem^c ; Albert Maroto^d ; Joan Figueras^c ; ^{info@jfigueras.net}
• 关键词：Estenosis arterial ; Tronco celiaco ; Duodenopancreatectom&iacute ; a ; Cá ; ncer de pá ; ncreas ; Tomograf&iacute ; a computarizada multidetector ; Cirug&iacute ; a ; Humanos
• 刊名：Cirug铆a Espa帽ola
• 出版年：2011
• 期刊代码：pca87_0009739X
• 类别：med
• 出版时间：April 2011
• 卷：89
• 期：4
• 页码：230-236
• 文件大小：557 K

Introduction

Significant celiac trunk or artery stenosis (CAS) is normally asymptomatic. However, when the arteries of the pancreatoduodenal arcade are occluded, it could trigger a visceral ischaemia. The objective of this study is to determine whether preoperative CAS is a risk factor for developing complications in patients subjected to duodenopancreatectomy (DPC).

Material and methods

We have retrospectively analysed 58 consecutive patients subjected to DPC. We have associated significant CAS with post-surgical outcome. In all cases a 16-channel multidetector computed tomography (MDCT) in three hepatic phases was performed. We have reviewed the pre-surgical MDCT focusing on the morphology of the celiac artery (CA), particularly in the presence or absence of significant stenosis (>50%).

Results

We found CAS >50%in 13 patients (22%). The overall mortality was 5%(3 patients). Serious complications developed in 16 (28%) patients, 8 (62%) of whom belonged to the group with significant CAS (P = .004). Ten patients (17%) had a pancreatic fistula, 5 (38%) vs. 5 (11%) (P = .036); Fourteen patients (24%) needed new surgery, 7 (54%) vs. 7 (16%) (P = .009); Seven patients (12%) had a haemoperitoneum, 4 (31%) vs. 3 (7%) (P = .038), in the group with and without CAS, respectively.

Conclusions

Significant radiological CAS is a risk factor of serious complications after DPC. The study of the calibre of the superior mesenteric artery (SMA) with MDCT should be routine before a DPC. The correction of a significant CAS should be evaluated preoperatively.