title: Autogenous vein graft from iliac artery to splenic artery for celiac occlusion in pancreaticoduodenectomy.
abstract: 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.
authors.affiliation: Department of Surgery, Jichi Medical School, Omiya Medical Center, Saitama 330-8503, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Okamoto
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Suminaga
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Toyama
authors.forename: Fumio
authors.initials: F
authors.lastname: Konishi
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kawahito
mesh_terms: D014670:Ampulla of Vater; D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000601:surgery*; D002445:Celiac Artery; D003097:Collateral Circulation; D003138:Common Bile Duct Neoplasms / Q000150:complications*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008099:Liver / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy; D012501:Saphenous Vein / Q000637:transplantation; D013157:Splenic Artery / Q000601:surgery*; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000379:methods*