Ozdemir Gorkem, Olmez Tolga, Dilek Okan, Eyi Berkay, Sozutek Alper, Seker Ahmet
Department of Gastroenterological Surgery, Adana City Training and Research Hospital, 01370 Adana, Turkey.
Department of Radiology, Adana City Training and Research Hospital, 01370 Adana, Turkey.
Tomography. 2025 Jan 14;11(1):9. doi: 10.3390/tomography11010009.
BACKGROUND/OBJECTIVES: The aim was to investigate the association between variations in the dorsal pancreatic artery (DPA) and intrapancreatic arcade anatomy with Whipple procedure outcomes and postoperative complications.
This retrospective study was conducted with 362 patients who underwent a Whipple procedure at the Department of Gastroenterological Surgery of Adana City Training and Research Hospital between January 2018 and April 2024. All data collected from medical records were compared and statistically analyzed according to the patients' survival status and arcade subtypes.
After excluding cases that did not meet the study criteria, a total of 284 patients were included in the study. DPA was visualized in 55.98% (159/284) of patients, while the intrapancreatic arcade was observed in 25% (71/284). The most common origin of the DPA was the splenic artery in 69.2% (n = 110) of patients, followed by the superior mesenteric artery in 17.6% (n = 28). The frequency of intrapancreatic arcade anatomy variations was as follows: type 1: 28.2% (n = 20), type 2: 49.3% (n = 35) and type 3: 22.5% (n = 16). Arcade type 4 anatomy was not detected. Postoperative pancreatic fistula (POPF) complication was found to be statistically significantly higher in patients with type 3 anatomy ( = 0.042). The 90-day mortality and long-term mortality rates did not differ among the groups based on the variations in both DPA and intrapancreatic arcade anatomy types.
Patients with intrapancreatic arcade type 3 anatomy had a higher risk of POPF complications. Determination of preoperative arcade type by computed tomography (CT) angiography may help to predict the risk of POPF.
背景/目的：本研究旨在探讨胰背动脉（DPA）变异和胰内动脉弓解剖结构与Whipple手术结局及术后并发症之间的关联。
本回顾性研究纳入了2018年1月至2024年4月在阿达纳市培训与研究医院胃肠外科接受Whipple手术的362例患者。根据患者的生存状况和动脉弓亚型，对从病历中收集的所有数据进行比较和统计分析。
排除不符合研究标准的病例后，共有284例患者纳入研究。55.98%（159/284）的患者可见DPA，25%（71/284）观察到胰内动脉弓。DPA最常见的起源是脾动脉，占69.2%（n = 110）的患者，其次是肠系膜上动脉，占17.6%（n = 28）。胰内动脉弓解剖结构变异的频率如下：1型：28.2%（n = 20），2型：49.3%（n = 35），3型：22.5%（n = 16）。未检测到4型动脉弓解剖结构。发现3型解剖结构的患者术后胰瘘（POPF）并发症在统计学上显著更高（ = 0.042）。基于DPA和胰内动脉弓解剖结构类型的变异，各亚组之间的90天死亡率和长期死亡率无差异。
胰内动脉弓3型解剖结构的患者发生POPF并发症的风险更高。通过计算机断层扫描（CT）血管造影术前确定动脉弓类型可能有助于预测POPF风险。
