Berselli Mattia, Sperti Cosimo, Ballotta Enzo, Beltrame Valentina, Pedrazzoli Sergio
Department of Medical and Surgical Sciences, Clinica Chirurgica IV, University of Padua, Via Giustiniani 2, 35128, Padua, Italy.
Updates Surg. 2010 Oct;62(2):117-20. doi: 10.1007/s13304-010-0015-x. Epub 2010 Aug 20.
Celiac axis stenosis is a relatively common finding that may require major revascularization during pancreaticoduodenectomy. We present a patient that underwent pancreaticoduodenectomy for intraductal papillary mucinous neoplasm of the pancreatic head associated with celiac axis obstruction. To secure arterial blood flow to the upper abdominal organs, the superior posterior pancreaticoduodenal artery and the posterior-inferior pancreatic-duodenal artery were carefully preserved, and anastomosed. The postoperative course was complicated by a pseudoaneurysm of the splenic artery that was successfully treated with angiographic embolization through the vascular bypass. This may be a valid alternative procedure for revascularization of the common hepatic artery during pancreaticoduodenectomy in a patient with celiac axis stenosis.
腹腔干狭窄是一种相对常见的情况，在胰十二指肠切除术中可能需要进行主要的血管重建。我们报告了一名因胰头导管内乳头状黏液性肿瘤合并腹腔干梗阻而接受胰十二指肠切除术的患者。为确保上腹部器官的动脉血流，仔细保留并吻合了胰十二指肠后上动脉和胰十二指肠后下动脉。术后病程因脾动脉假性动脉瘤而复杂化，通过血管旁路进行血管造影栓塞成功治疗。对于腹腔干狭窄患者，这可能是胰十二指肠切除术中肝总动脉血管重建的一种有效替代方法。
