The unrecognized posterior gastric artery: a potential cause of surgical complications in pancreas transplantation.
BACKGROUND
Our report describes, for the first time, a pre-transplant vascular complication in a pancreas graft related to the posterior gastric artery - a major, but relatively unknown side branch of the splenic artery. The posterior gastric artery that was overlooked by a surgical procurement team during donor pancreatectomy led to distortion of the peripancreatic vascular anatomy and set the stage for a splenic artery injury.


METHODS
We identified the transected, partially resected graft splenic artery during backtable preparation of the pancreas, and repaired it using standard vascular surgical techniques.


RESULTS
The recipient's post-operative course was uncomplicated. At 9-yr post-transplant, the recipient is alive with good pancreas graft function.


CONCLUSIONS
The relevance of the posterior gastric artery with regard to general surgical procedures was only recently recognized. Our case demonstrates that the posterior gastric artery is also important in transplant surgery. Awareness of this anatomical structure during organ procurement would help minimize pre-transplant vascular complications.
Troppmann
Christoph
C
Department of Surgery, UC Davis Medical Center, University of California, Sacramento, CA, USA. christoph.troppmann@ucdmc.ucdavis.edu
Pirenne
Jacques
J
Perez
Richard V
RV
Gruessner
Rainer W G
RW
D000328:Adult; D000714:Anastomosis, Surgical; D001158:Arteries / Q000033:anatomy & histology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D013157:Splenic Artery / Q000033:anatomy & histology / Q000601:surgery; D013270:Stomach / Q000098:blood supply*; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting