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Journal of Gastrointestinal Cancer
Published in: Journal of Gastrointestinal Cancer 4/2023

10-06-2023 | Case Report

Pancreaticoduodenectomy in a Case with Celiac Axis Stenosis: A Surgical Challenge

Authors: Saneya Pandrowala, Vipul Gupta, Manish S. Bhandare, Shailesh V. Shrikhande

Published in: Journal of Gastrointestinal Cancer | Issue 4/2023

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Excerpt

Celiac axis stenosis (CAS) has been increasingly reported on the preoperative radiology with an incidence of 10–25% [1, 2]. Patients having chronic CAS develop collateral pathways between CA and superior mesenteric artery (SMA), commonly via gastroduodenal artery (GDA) to supply upper abdominal visceral organs [3]. Division of GDA during pancreaticoduodenectomy (PD) may cause ischemic damage to these organs, thus increasing the risk of anastomotic leaks which can result in higher post-operative morbidity and mortality [4, 5]. …
Literature
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Kwon JW, Chung JW, Song SY, et al. Transcatheter arterial chemoembolization for hepatocellular carcinomas in patients with celiac axis occlusion. J Vasc Interv Radiol. 2002;13:689–94.CrossRefPubMed
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Song SY, Chung JW, Kwon JW, et al. Collateral pathways in patients with celiac axis stenosis: angiographic-spiral CT correlation. Radiographics. 2002;22:881–93.CrossRefPubMed
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Sugae T, Fujii T, Kodera Y, et al. Classification of the celiac axis stenosis owing to median arcuate ligament compression, based on severity of the stenosis with subsequent proposals for management during pancreatoduodenectomy. Surgery. 2012;151(4):543–9.CrossRefPubMed
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Zhou Y, Wang W, Shi Y, Lu X, Zhan Q, Chen H, Deng X, Peng C, Shen B. Substantial atherosclerotic celiac axis stenosis is a new risk factor for biliary fistula after pancreaticoduodenectomy. Int J Surg. 2018;1(49):62–7.CrossRef
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Al-Saeedi M, Sauer HB, Ramouz A, Koch JM, Frank-Moldzio L, Bruckner T, Loos M, Mayer P, Klauss M, Kulu Y, Berchtold C. Celiac axis stenosis is an underestimated risk factor for increased morbidity after pancreatoduodenectomy. Annals of Surgery. 2022.
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Ouassi M, Ouaissi M, Verhelst R, et al. Celiac artery occlusive disease: a rare but potentially critical condition in patients undergoing pancreaticoduodenectomy. Hepatogastroenterology. 2011;58:1377–83.CrossRefPubMed
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Giovanardi F, Lai Q, Garofalo M, et al. Collaterals management during pancreatoduodenectomy in patients with celiac axis stenosis: a systematic review of the literature. Pancreatology. 2018;18(5):592–600.CrossRefPubMed
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Metadata
Title
Pancreaticoduodenectomy in a Case with Celiac Axis Stenosis: A Surgical Challenge
Authors
Saneya Pandrowala
Vipul Gupta
Manish S. Bhandare
Shailesh V. Shrikhande
Publication date
10-06-2023
Publisher
Springer US
Published in
Journal of Gastrointestinal Cancer / Issue 4/2023
Print ISSN: 1941-6628
Electronic ISSN: 1941-6636
DOI
https://doi.org/10.1007/s12029-023-00948-x

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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