title: [Celiac artery stenosis and cephalic duodenopancreatectomy: an undervalued risk?].
abstract: BACKGROUND
  Significant celiac trunk or artery stenosis (CAS) is normally asymptomatic. However, when the arteries of the pancreatoduodenal arcade are occluded, it could trigger a visceral ischaemia. The objective of this study is to determine whether preoperative CAS is a risk factor for developing complications in patients subjected to duodenopancreatectomy (DPC).
  
  
  METHODS
  We have retrospectively analysed 58 consecutive patients subjected to DPC. We have associated significant CAS with post-surgical outcome. In all cases a 16-channel multidetector computed tomography (MDCT) in three hepatic phases was performed. We have reviewed the pre-surgical MDCT focusing on the morphology of the celiac artery (CA), particularly in the presence or absence of significant stenosis (>50%).
  
  
  RESULTS
  We found CAS >50% in 13 patients (22%). The overall mortality was 5% (3 patients). Serious complications developed in 16 (28%) patients, 8 (62%) of whom belonged to the group with significant CAS (P=.004). Ten patients (17%) had a pancreatic fistula, 5 (38%) vs. 5 (11%) (P=.036); Fourteen patients (24%) needed new surgery, 7 (54%) vs. 7 (16%) (P=.009); Seven patients (12%) had a haemoperitoneum, 4 (31%) vs. 3 (7%) (P=.038), in the group with and without CAS, respectively.
  
  
  CONCLUSIONS
  Significant radiological CAS is a risk factor of serious complications after DPC. The study of the calibre of the superior mesenteric artery (SMA) with MDCT should be routine before a DPC. The correction of a significant CAS should be evaluated preoperatively.
authors.affiliation: Servicio de Cirugía, Hospital de Getafe, Getafe, Madrid, España.
authors.forename: José
authors.initials: J
authors.lastname: Muros
authors.forename: Jordi
authors.initials: J
authors.lastname: Soriano
authors.forename: Antonio
authors.initials: A
authors.lastname: Codina-Barreras
authors.forename: Pere
authors.initials: P
authors.lastname: Planellas
authors.forename: Santiago
authors.initials: S
authors.lastname: Lopez-Ben
authors.forename: Maite
authors.initials: M
authors.lastname: Albiol
authors.forename: Laia
authors.initials: L
authors.lastname: Falgueras
authors.forename: Ernesto
authors.initials: E
authors.lastname: Castro
authors.forename: Anna
authors.initials: A
authors.lastname: Pigem
authors.forename: Albert
authors.initials: A
authors.lastname: Maroto
authors.forename: Joan
authors.initials: J
authors.lastname: Figueras
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications*; D002445:Celiac Artery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors