title: Vascular challenges from pancreatoduodenectomy in the setting of coeliac artery stenosis.
abstract: Coeliac artery stenosis due to median arcuate ligament compression or atherosclerotic disease is a frequently unrecognised challenge to recovery after pancreatoduodenectomy. The described case illustrates management with intraoperative superior mesenteric artery to hepatic artery bypass graft that led to haemorrhagic challenges postoperatively but ultimately a good recovery. Aspects of preoperative diagnosis, preoperative intervention and intraoperative management options are reviewed. Surgeons need to possess these tools to prevent complications from coeliac artery stenosis when pancreatoduodenectomy is required.
authors.affiliation: Department of Surgery Division of Surgical Oncology, Indiana University School of Medicine, South Bend, Goshen, Indiana, USA.
authors.forename: Joal D
authors.initials: JD
authors.lastname: Beane
authors.affiliation: Department of Surgery Division of Surgical Oncology, Indiana University School of Medicine, South Bend, Goshen, Indiana, USA.
authors.forename: Roderich E
authors.initials: RE
authors.lastname: Schwarz
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology; D000368:Aged; D000792:Angiography; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures / Q000009:adverse effects*