Ellebrecht D B, Jung C F M, Hoffmann M, Keck T
Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Deutschland.
Zentralbl Chir. 2016 Oct;141(5):505-508. doi: 10.1055/s-0042-102534. Epub 2016 Jun 13.
The coeliac artery compression syndrome, first described by Harjola und Dunbar, results from the coeliac artery and plexus being compressed by the arcuate ligament at their origin. The clinical symptoms are postprandial pain and weight loss and the syndrome significantly restricts patients' quality of life. In rare cases, an epigastric bruit is detected on clinical examination. Laparoscopic division of the arcuate ligament is a successful option for the treatment of the coeliac artery compression syndrome. Laparoscopic decompression is indicated for patients with a symptom triad of postprandial pain, weight loss and epigastric bruit and radiologic confirmation of coeliac artery compression by duplex sonography, computed tomography angiography or magnetic resonance angiography. The operative strategy is based on the division of the arcuate ligament following its visualisation above the origin of the coeliac artery from the abdominal aorta. The laparoscopic division of the arcuate ligament and the resection of the coeliac plexus are a largely uneventful, minimally-invasive option to treat the coeliac artery compression syndrome and restore patients' quality of life.
腹腔干压迫综合征最早由哈尔约拉和邓巴描述，是由于腹腔干及其神经丛在起始处被弓状韧带压迫所致。临床症状为餐后疼痛和体重减轻，该综合征严重限制了患者的生活质量。在罕见情况下，临床检查可发现上腹部杂音。腹腔镜下切断弓状韧带是治疗腹腔干压迫综合征的一种成功选择。对于有餐后疼痛、体重减轻和上腹部杂音三联征且经双功超声、计算机断层血管造影或磁共振血管造影影像学证实腹腔干受压的患者，可进行腹腔镜减压。手术策略是在从腹主动脉观察到腹腔干起始部上方的弓状韧带后将其切断。腹腔镜下切断弓状韧带并切除腹腔神经丛是治疗腹腔干压迫综合征并恢复患者生活质量的一种基本顺利的微创选择。
