title: Celiac axis occlusion with replaced common hepatic artery and pancreatoduodenectomy.
abstract: A rare case of intraductal papillary mucinous tumor of the pancreas associated with a replaced common hepatic artery and celiac axis occlusion, which was treated by pancreatoduodenectomy, is reported. In this patient, the celiac trunk was occluded at its root and the splenic and left gastric artery could be visualized serially via the enlarged collateral artery on superior mesenteric arteriography. At surgery, the collateral artery was carefully preserved and pancreatoduodenectomy was successfully performed without ischemia of the stomach, spleen, and remnant pancreas. Although celiac axis occlusion is an uncommon finding for patients undergoing pancreatoduodenectomy, we recommend performing celio-mesenteric angiography before pancreatoduodenectomy, and, at surgery, clamping of the gastroduodenal artery is required for patients with celiac axis occlusion.
authors.affiliation: Department of Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. mura777@hiroshima-u.ac.jp
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Murakami
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Uemura
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Masaru
authors.initials: M
authors.lastname: Sasaki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Morifuji
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hayashidani
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sudo
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
mesh_terms: D001157:Arterial Occlusive Diseases / Q000150:complications / Q000601:surgery*; D002445:Celiac Artery; D018291:Cystadenoma, Mucinous / Q000150:complications / Q000601:surgery*; D005260:Female; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000150:complications / Q000601:surgery*; D016577:Pancreaticoduodenectomy