Managing arterial collaterals due to coeliac axis stenosis during pancreaticoduodenectomy.
BACKGROUND
Coeliac artery stenosis is a condition affecting a minority of patients undergoing pancreaticoduodenectomy. In such cases, the development of collateral pathways through the blood supply of the pancreatic head provides challenges for surgical management.


METHODS
We report a case of coeliac artery stenosis in a patient undergoing pancreaticoduodenectomy. The main blood supply for the coeliac axis was through a single collateral channel, formed by the anterior pancreaticoduodenal arterial arcade. We describe the preservation of this arcade, resection of the redundant artery with primary anastomosis and a review of the literature.


CONCLUSIONS
Management of coeliac artery stenosis during pancreaticoduodenectomy depends on identifying the cause and dealing with it accordingly, intraoperatively.
El-Ghazaly Harb
Shady T
ST
Institute of Liver Studies, Kings College Hospital, London, UK.
O'Sullivan
Adrian W
AW
Marangoni
Gabriele
G
Heaton
Nigel D
ND
Rela
Mohamed
M
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002445:Celiac Artery / Q000473:pathology*; D003097:Collateral Circulation / Q000502:physiology; D003251:Constriction, Pathologic / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008954:Models, Biological; D010179:Pancreas / Q000098:blood supply / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*