Yoshida E, Kimura Y, Kyuno T, Kawagishi R, Sato K, Kono T, Chiba T, Kimura T, Yonezawa H, Funato O, Kobayashi M, Murakami K, Takagane A, Takemasa I. Treatment strategy for pancreatic head cancer with celiac axis stenosis in pancreaticoduodenectomy: A case report and review of literature. World J Gastroenterol. 2022 Feb 28;28(8):868-877. doi: 10.3748/wjg.v28.i8.868. PMID: 35317096; PMCID: PMC8900579.
Abstract
Background: During pancreaticoduodenectomy in patients with celiac axis (CA) stenosis due to compression by the median arcuate ligament (MAL), the MAL has to be divided to maintain hepatic blood flow in many cases. However, MAL division often fails, and success can only be determined intraoperatively. To overcome this problem, we performed endovascular CA stenting preoperatively, and thereafter safely performed pancreaticoduodenectomy. We present this case as a new preoperative treatment strategy that was successful.