Premium
Early ligation of the dorsal pancreatic artery with a mesenteric approach reduces intraoperative blood loss during pancreatoduodenectomy
Author(s) -
Iede Kiyotsugu,
Nakao Akimasa,
Oshima Kenji,
Suzuki Ryota,
Yamada Hironori,
Oshima Yukiko,
Kobayashi Hironobu,
Kimura Yasunori
Publication year - 2018
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.562
Subject(s) - ligation , medicine , pancreaticoduodenectomy , superior mesenteric artery , blood loss , surgery , artery , pancreas
Background Early ligation of the inferior pancreatoduodenal artery has been advocated to reduce blood loss during pancreatoduodenectomy. However, the impact of early ligation of the dorsal pancreatic artery ( DPA ) remains unclear. This study was performed to investigate the clinical implications of early ligation of the DPA . Methods From October 2014 to April 2017, 34 consecutive patients underwent pancreatoduodenectomy using a mesenteric approach. The patients were divided into the early DPA ligation group ( n = 15) and late DPA ligation group ( n = 19). The clinical features were retrospectively compared between the two groups (H29‐044). Results Preoperative multidetector row computed tomography and intraoperative findings revealed that the right branch of the DPA supplied the pancreatic head region in all cases. Intraoperative blood loss was significantly lower in the early than late ligation group (median 609 ml [range 94–1,013 ml] vs. 764 ml [range 367–1,828 ml], respectively; P = 0.008). Multivariable analysis revealed that early DPA ligation was independently associated with blood loss ( P = 0.023). The DPA s arising from the superior mesenteric artery underwent early ligation at a significantly higher rate. Conclusions Early ligation of the DPA during pancreaticoduodenectomy with a mesenteric approach could reduce intraoperative blood loss.