title: Distance from Left Renal Vein to Inferior Pancreaticoduodenal Artery: A Landmark for Identifying Inferior Pancreaticoduodenal Artery in Pancreatoduodenectomy.
abstract: OBJECTIVE
  During pancreatoduodenectomy, early ligation of major afferent arteries to pancreatic head prior to dissection of the corresponding veins may reduce intraoperative bleeding. Inferior pancreaticoduodenal artery (IPDA), one of the major afferent arteries, is difficult to identify. We measured the distance from left renal vein to IPDA based on preoperative multi-detector row computed tomography (MDCT) images for use as a new landmark for IPDA.
  
  
  METHODS
  The distance between left renal vein and IPDA was measured in 417 patients using MDCT images.
  
  
  RESULTS
  IPDA was identified on MDCT images in 415 out of the 417 patients (99.5%). The root of IPDA was located on cranial side of the root of left renal vein in 88 among the 415 patients (21.2%), and the distance was expressed as negative in these cases. The distance was 6.09 ± 7.46 mm. The distance when IPDA formed a common vessel with first jejunal artery (8.03 ± 6.74 mm; 323 cases, 77.8%) was significantly longer than when IPDA branched directly from superior mesenteric artery (SMA; -0.81 ± 5.74 mm; 62 cases, 15.0%) or posterior and anterior IPDAs branched separately from SMA (-2.04 ± 5.36 mm; 30 cases, 7.2%).
  
  
  CONCLUSIONS
  The distance between left renal vein and IPDA can serve as a landmark for IPDA identification.
authors.affiliation: Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tomimaru
authors.forename: Kaishu
authors.initials: K
authors.lastname: Tanaka
authors.forename: Kozo
authors.initials: K
authors.lastname: Noguchi
authors.forename: Hisanori
authors.initials: H
authors.lastname: Hatano
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Eguchi
authors.forename: Keizo
authors.initials: K
authors.lastname: Dono
mesh_terms: D059925:Anatomic Landmarks / Q000000981:diagnostic imaging*; D001158:Arteries / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006801:Humans; D061330:Multidetector Computed Tomography; D010179:Pancreas / Q000098:blood supply*; D016577:Pancreaticoduodenectomy; D012082:Renal Veins / Q000033:anatomy & histology* / Q000000981:diagnostic imaging
keywords: Inferior pancreaticoduodenal artery; Left renal vein; Pancreatoduodenectomy