title: Arteriography after embolization before distal pancreatectomy with en bloc celiac axis resection.
abstract: OBJECTIVE
  To evaluate hemodynamics by arteriographic examinations with and without CT in the stomach wall and liver after preoperative embolization to redistribute blood flow to the stomach and liver, which is unified to be supplied from the superior mesenteric artery, before distal pancreatectomy with en bloc celiac axis resection (DP-CAR).
  
  
  METHODS
  In six patients with locally advanced cancer of the pancreatic body in whom DP-CAR was planned, the left gastric artery and common hepatic artery were embolized with coils. Celiac arteriography and superior mesenteric arteriography with and without CT were performed after embolization.
  
  
  RESULTS
  In all six patients, intrahepatic arteries and the left gastric artery were not visualized on celiac arteriography. On both superior mesenteric arteriography and CT obtained while contrast medium was infused via the superior mesenteric artery and which was performed immediately after embolization procedures, the right gastric artery, gastroepiploic artery, gastroduodenal artery, and all hepatic arterial branches were clearly detected. Also the distal part of the left gastric artery close to the embolized point was detected with at least one of the imaging modalities.
  
  
  CONCLUSIONS
  It was clarified radiologically that preoperative embolization results in increased blood supply to the stomach wall and liver through the pancreatic arcade.
authors: a 1 Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima University , Hiroshima, Japan.|b 2 Department of Radiology, Kochi University Medical School , Kochi, Japan.
authors: Takuji
authors: T
authors: Yamagami
authors: a 1 Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima University , Hiroshima, Japan.|b 2 Department of Radiology, Kochi University Medical School , Kochi, Japan.
authors: Rika
authors: R
authors: Yoshimatsu
authors: a 1 Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima University , Hiroshima, Japan.
authors: Kenji
authors: K
authors: Kajiwara
authors: a 1 Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima University , Hiroshima, Japan.
authors: Masaki
authors: M
authors: Ishikawa
authors: c 3 Department of Surgery, Institute and Graduate School of Biomedical Sciences, Hiroshima University , Hiroshima, Japan.
authors: Yoshiaki
authors: Y
authors: Murakami
authors: c 3 Department of Surgery, Institute and Graduate School of Biomedical Sciences, Hiroshima University , Hiroshima, Japan.
authors: Kenichiro
authors: K
authors: Uemura
authors: a 1 Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences, Hiroshima University , Hiroshima, Japan.
authors: Kazuo
authors: K
authors: Awai
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods*; D002445:Celiac Artery / Q000601:surgery; D003287:Contrast Media / Q000008:administration & dosage; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000098:blood supply; D008297:Male; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D013270:Stomach / Q000098:blood supply; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D003287:Contrast Media
keywords: Distal pancreatectomy; pancreatic cancer; preoperative embolization