title: Laparoscopic surgery for coeliac artery compression syndrome: current management and technical aspects.
abstract: OBJECTIVE
  The study aims to assess the feasibility and midterm outcome of trans-peritoneal laparoscopy for coeliac artery compression syndrome (CACS).
  
  
  METHODS
  Retrospective chart review involving four European vascular surgery departments and two surgical teams.
  
  
  METHODS
  charts for patients who underwent laparoscopy for symptomatic CACS between December 2003 and November 2009 were reviewed. Preoperative computed tomography (CT) angiography and postoperative duplex scan and/or CT angiography were performed.
  
  
  RESULTS
  Eleven consecutive patients (nine women) with a median age of 52 years (interquartile range: 42.5-59 years) underwent trans-peritoneal laparoscopy for CACS. All patients had a history of postprandial abdominal pain; weight loss exceeded 10% of the body mass in eight cases. Preoperative CT angiography revealed coeliac trunk stenosis >70% in all cases. One patient had additional aortitis and inferior mesenteric artery occlusion, while another patient presented with an occluded superior mesenteric artery. Two conversions occurred (one difficult dissection and one aorto-hepatic bypass needed for incomplete release of CACS). The median blood loss was 195 ml (range: 50-900 ml) and median operative time was 80 min (interquartile range: 65-162.5 years). Symptoms improved immediately in 10/11 patients (no residual stenosis) while one remained unchanged despite a residual stenosis treated by a percutaneous angioplasty. Symptoms reappeared in one patient due to coeliac axis occlusion. The mean follow-up period was 35 ± 23 months (range: 12-78 months).
  
  
  CONCLUSIONS
  Our study demonstrates that trans-peritoneal laparoscopy for treating median arcuate ligament syndrome is safe and feasible. Additional patients and a longer follow-up are needed for long-term assessment of this laparoscopic technique.
authors: Department of Vascular Surgery, University Hospital of Bordeaux, Tripode-Pellegrin, Place Amelie Raba Leon, 33000 Bordeaux, France. xavier.berard@chu-bordeaux.fr
authors: X
authors: X
authors: Berard
authors: J
authors: J
authors: Cau
authors: S
authors: S
authors: Déglise
authors: D
authors: D
authors: Trombert
authors: B
authors: B
authors: Saint-Lebes
authors: D
authors: D
authors: Midy
authors: J M
authors: JM
authors: Corpataux
authors: J B
authors: JB
authors: Ricco
mesh_terms: D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D002445:Celiac Artery / Q000000981:diagnostic imaging; D003251:Constriction, Pathologic; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D005060:Europe; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008022:Ligaments / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex