title: Pancreaticoduodenectomy with unusual artery reconstruction in a patient with celiac axis occlusion: report of a case.
abstract: Celiac axis stenosis is a relatively common finding that may require major revascularization during pancreaticoduodenectomy. We present a patient that underwent pancreaticoduodenectomy for intraductal papillary mucinous neoplasm of the pancreatic head associated with celiac axis obstruction. To secure arterial blood flow to the upper abdominal organs, the superior posterior pancreaticoduodenal artery and the posterior-inferior pancreatic-duodenal artery were carefully preserved, and anastomosed. The postoperative course was complicated by a pseudoaneurysm of the splenic artery that was successfully treated with angiographic embolization through the vascular bypass. This may be a valid alternative procedure for revascularization of the common hepatic artery during pancreaticoduodenectomy in a patient with celiac axis stenosis.
authors.affiliation: Department of Medical and Surgical Sciences, Clinica Chirurgica IV, University of Padua, Via Giustiniani 2, 35128, Padua, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Berselli
authors.forename: Cosimo
authors.initials: C
authors.lastname: Sperti
authors.forename: Enzo
authors.initials: E
authors.lastname: Ballotta
authors.forename: Valentina
authors.initials: V
authors.lastname: Beltrame
authors.forename: Sergio
authors.initials: S
authors.lastname: Pedrazzoli
mesh_terms: D002445:Celiac Artery; D006499:Hepatic Artery / Q000601:surgery; D006801:Humans; D010179:Pancreas / Q000601:surgery; D010180:Pancreatectomy; D016577:Pancreaticoduodenectomy