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Autogenous vein graft from iliac artery to splenic artery for celiac occlusion in pancreaticoduodenectomy
Author(s) -
Okamoto Hideki,
Suminaga Yoshihisa,
Toyama Nobuyuki,
Konishi Fumio,
Kawahito Hirotsugu
Publication year - 2003
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s10534-002-0831-7
Subject(s) - medicine , pancreaticoduodenectomy , gastroduodenal artery , splenic artery , occlusion , superior mesenteric artery , surgery , celiac artery , external iliac artery , splenic vein , artery , radiology , superior mesenteric vein , portal vein , portal hypertension , resection , cirrhosis
This is a report of two patients with bile duct cancer and periampullary cancer with celiac axis occlusion who underwent pylorus‐preserving pancreaticoduodenectomy and pancreaticoduodenectomy, respectively. Preoperative arteriography demonstrated complete obstruction of the celiac axis. The arterial blood flow to the liver, spleen, and stomach was sustained through the pancreaticoduodenal arcades and collaterals from the superior mesenteric artery. Therefore, reconstruction of the celiac axis circulation was required before division of the gastroduodenal artery. An autograft of the saphenous vein was placed between the iliac artery and the splenic artery, and subsequently pancreaticoduodenectomy was performed. The patients' postoperative courses were uneventful. Postoperative arteriography demonstrated patency of the grafts. When occlusion of the celiac axis exists, a bypass from the iliac artery to the splenic artery using a saphenous vein graft, may be safely and easily performed at the time of pancreaticoduodenal resection.