Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Asian J Endosc Surg. 2024 Apr;17(2):e13288. doi: 10.1111/ases.13288.
Surgical treatment of celiac artery (CA) compression syndrome (CACS) is to release the median arcuate ligament (MAL) by removing the abdominal nerve plexus surrounding CA. In laparoscopic surgery of CACS, objective intraoperative assessment of blood flow in CA is highly desirable. We herein demonstrate a case of laparoscopic surgery of CACS with use of intraoperative transabdominal ultrasound. A 52-year-old woman was presented with epigastric pain and vomiting after eating. Contrast-enhanced computed tomography demonstrated significant stenosis at the origin of CA. Doppler study of CA was also performed, and she was diagnosed as CACS. Laparoscopic surgery was performed, and the MAL was divided. And then, Doppler study using intraoperative transabdominal ultrasound confirmed the successful decompression of CA. This patient was discharged on postoperative day 11, and her symptoms was improved. Intraoperative assessment of blood flow in CA using transabdominal ultrasound was a simple and useful method for laparoscopic surgery of CACS.
腹腔动脉(CA)压迫综合征(CACS)的手术治疗方法是通过切除环绕 CA 的腹部神经丛来松解正中弓状韧带(MAL)。在腹腔镜治疗 CACS 中,非常希望能够对 CA 的血流进行客观的术中评估。本文展示了一例使用术中经腹超声的腹腔镜 CACS 手术。一名 52 岁女性在进食后出现上腹痛和呕吐。增强 CT 显示 CA 起始处明显狭窄。还进行了 CA 的多普勒研究,诊断为 CACS。行腹腔镜手术,分离 MAL。然后,使用术中经腹超声的多普勒研究确认 CA 减压成功。该患者术后第 11 天出院,症状改善。经腹超声对 CA 血流的术中评估是腹腔镜治疗 CACS 的一种简单而有用的方法。