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Erschienen in: CardioVascular and Interventional Radiology 5/2011

01.10.2011 | Technical Note

Distal Pancreatectomy With En Bloc Resection of the Celiac Trunk for Extended Pancreatic Tumor Disease: An Interdisciplinary Approach

verfasst von: Timm Denecke, Andreas Andreou, Petr Podrabsky, Christian Grieser, Peter Warnick, Marcus Bahra, Fritz Klein, Bernd Hamm, Peter Neuhaus, Matthias Glanemann

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 5/2011

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Abstract

Purpose

Infiltration of the celiac trunk by adenocarcinoma of the pancreatic body has been considered a contraindication for surgical treatment, thus resulting in a very poor prognosis. The concept of distal pancreatectomy with resection of the celiac trunk offers a curative treatment option but implies the risk of relevant hepatic or gastric ischemia. We describe initial experiences in a small series of patients with left celiacopancreatectomy with or without angiographic preconditioning of arterial blood flow to the stomach and the liver.

Materials and Methods

Between January 2007 and October 2009, six patients underwent simultaneous resection of the celiac trunk for adenocarcinoma of the pancreatic body involving the celiac axis. In four of these cases, angiographic occlusion of the celiac trunk before surgery was performed to enhance collateral flow from the gastroduodenal artery. Radiologic and surgical procedures, findings, and outcome were analyzed retrospectively.

Results

Complete tumor removal (R0) succeeded in two patients, whereas four patients underwent R1-tumor resection. After surgery, one of the two patients without angiographic preparation experienced an ischemic stomach perforation 1 week after surgery. The other patient died from severe bleeding from an ischemic gastric ulcer. Of the four patients with celiac trunk embolization, none presented ischemic complications after surgery. Mean survival was 371 days.

Conclusion

In this small series, ischemic complications after celiacopancreatectomy occurred only in those patients who did not receive preoperative celiac trunk embolization.
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Metadaten
Titel
Distal Pancreatectomy With En Bloc Resection of the Celiac Trunk for Extended Pancreatic Tumor Disease: An Interdisciplinary Approach
verfasst von
Timm Denecke
Andreas Andreou
Petr Podrabsky
Christian Grieser
Peter Warnick
Marcus Bahra
Fritz Klein
Bernd Hamm
Peter Neuhaus
Matthias Glanemann
Publikationsdatum
01.10.2011
Verlag
Springer-Verlag
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 5/2011
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-010-9997-5

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