Distal Pancreatectomy with Celiac Axis Resection Combined with Reconstruction of the Left Gastric Artery
Distal pancreatectomy with celiac axis resection is one of the most aggressive approaches for the treatment of locally advanced pancreatic cancer with common hepatic artery and/or celiac axis invasion. However, ischemic complications such as ischemic gastropathy and liver failure are problematic. To...
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| Veröffentlicht in: | Journal of gastrointestinal surgery 2017-05, Vol.21 (5), p.910-917 |
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| container_title | Journal of gastrointestinal surgery |
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| creator | Sato, Takafumi Inoue, Yosuke Takahashi, Yu Mise, Yoshihiro Ishizawa, Takeaki Tanakura, Kenta Ito, Hiromichi Saiura, Akio |
| description | Distal pancreatectomy with celiac axis resection is one of the most aggressive approaches for the treatment of locally advanced pancreatic cancer with common hepatic artery and/or celiac axis invasion. However, ischemic complications such as ischemic gastropathy and liver failure are problematic. To avoid these complications, we developed left gastric artery-reconstructing distal pancreatectomy with celiac axis resection. We used the middle colic artery for reconstruction. We performed this procedure in 10 patients, using the middle colic artery in three different ways: left branch reconstruction, right branch reconstruction, and reverse reconstruction. On postoperative images, 90% of the reconstructed left gastric arteries were patent. No complications associated with arterial reconstruction occurred. No patients developed ischemic gastropathy or liver failure. The R0 resection rate was 70%. Nine patients underwent adjuvant chemotherapy and seven patients were able to start it within 90 days. Distal pancreatectomy with celiac axis resection combined with reconstruction of the left gastric artery using the middle colic artery is a feasible option and would enhance the safety for carefully selected patients. Multicenter validation is needed to clarify the benefits of this new procedure. |
| doi_str_mv | 10.1007/s11605-017-3366-5 |
| format | Article |
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However, ischemic complications such as ischemic gastropathy and liver failure are problematic. To avoid these complications, we developed left gastric artery-reconstructing distal pancreatectomy with celiac axis resection. We used the middle colic artery for reconstruction. We performed this procedure in 10 patients, using the middle colic artery in three different ways: left branch reconstruction, right branch reconstruction, and reverse reconstruction. On postoperative images, 90% of the reconstructed left gastric arteries were patent. No complications associated with arterial reconstruction occurred. No patients developed ischemic gastropathy or liver failure. The R0 resection rate was 70%. Nine patients underwent adjuvant chemotherapy and seven patients were able to start it within 90 days. Distal pancreatectomy with celiac axis resection combined with reconstruction of the left gastric artery using the middle colic artery is a feasible option and would enhance the safety for carefully selected patients. Multicenter validation is needed to clarify the benefits of this new procedure.</description><identifier>ISSN: 1091-255X</identifier><identifier>EISSN: 1873-4626</identifier><identifier>DOI: 10.1007/s11605-017-3366-5</identifier><identifier>PMID: 28116666</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Aged ; Cancer research ; Cancer therapies ; Carcinoma, Pancreatic Ductal - surgery ; Celiac Artery - surgery ; Chemotherapy ; Dissection ; Female ; Fistula ; Gastroenterology ; Hepatic Artery - surgery ; How I do it ; Humans ; Ischemia ; Male ; Medical prognosis ; Medical research ; Medicine ; Medicine & Public Health ; Mesenteric Artery, Superior - surgery ; Middle Aged ; Pancreatectomy - methods ; Pancreatic cancer ; Pancreatic Neoplasms - surgery ; Plastic Surgery Procedures - methods ; Stomach - blood supply ; Surgery ; Surgical outcomes ; Vascular Surgical Procedures - methods ; Veins & arteries</subject><ispartof>Journal of gastrointestinal surgery, 2017-05, Vol.21 (5), p.910-917</ispartof><rights>The Society for Surgery of the Alimentary Tract 2017</rights><rights>Journal of Gastrointestinal Surgery is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-4a09858ea88354a4fcc5d02144fa4dd889be85f799fc59a645bf8a3f96a7556c3</citedby><cites>FETCH-LOGICAL-c372t-4a09858ea88354a4fcc5d02144fa4dd889be85f799fc59a645bf8a3f96a7556c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11605-017-3366-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11605-017-3366-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28116666$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sato, Takafumi</creatorcontrib><creatorcontrib>Inoue, Yosuke</creatorcontrib><creatorcontrib>Takahashi, Yu</creatorcontrib><creatorcontrib>Mise, Yoshihiro</creatorcontrib><creatorcontrib>Ishizawa, Takeaki</creatorcontrib><creatorcontrib>Tanakura, Kenta</creatorcontrib><creatorcontrib>Ito, Hiromichi</creatorcontrib><creatorcontrib>Saiura, Akio</creatorcontrib><title>Distal Pancreatectomy with Celiac Axis Resection Combined with Reconstruction of the Left Gastric Artery</title><title>Journal of gastrointestinal surgery</title><addtitle>J Gastrointest Surg</addtitle><addtitle>J Gastrointest Surg</addtitle><description>Distal pancreatectomy with celiac axis resection is one of the most aggressive approaches for the treatment of locally advanced pancreatic cancer with common hepatic artery and/or celiac axis invasion. However, ischemic complications such as ischemic gastropathy and liver failure are problematic. To avoid these complications, we developed left gastric artery-reconstructing distal pancreatectomy with celiac axis resection. We used the middle colic artery for reconstruction. We performed this procedure in 10 patients, using the middle colic artery in three different ways: left branch reconstruction, right branch reconstruction, and reverse reconstruction. On postoperative images, 90% of the reconstructed left gastric arteries were patent. No complications associated with arterial reconstruction occurred. No patients developed ischemic gastropathy or liver failure. The R0 resection rate was 70%. Nine patients underwent adjuvant chemotherapy and seven patients were able to start it within 90 days. Distal pancreatectomy with celiac axis resection combined with reconstruction of the left gastric artery using the middle colic artery is a feasible option and would enhance the safety for carefully selected patients. Multicenter validation is needed to clarify the benefits of this new procedure.</description><subject>Adult</subject><subject>Aged</subject><subject>Cancer research</subject><subject>Cancer therapies</subject><subject>Carcinoma, Pancreatic Ductal - surgery</subject><subject>Celiac Artery - surgery</subject><subject>Chemotherapy</subject><subject>Dissection</subject><subject>Female</subject><subject>Fistula</subject><subject>Gastroenterology</subject><subject>Hepatic Artery - surgery</subject><subject>How I do it</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mesenteric Artery, Superior - surgery</subject><subject>Middle Aged</subject><subject>Pancreatectomy - methods</subject><subject>Pancreatic cancer</subject><subject>Pancreatic Neoplasms - surgery</subject><subject>Plastic Surgery Procedures - methods</subject><subject>Stomach - blood supply</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Vascular Surgical Procedures - methods</subject><subject>Veins & arteries</subject><issn>1091-255X</issn><issn>1873-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kV1rHCEYhaU0ZPP1A3pThN70ZlKdUUcvw6bdBBYaQgK5E9d5zRpmxlQdkv33dZm0hEK9UTzPeZVzEPpEyTklpP2WKBWEV4S2VdMIUfEP6IjKtqmYqMXHciaKVjXnDwt0nNITKSCh8hAtalmcZR2h7aVP2fT4xow2gslgcxh2-MXnLV5C743FF68-4VtIRfJhxMswbPwI3czcgg1jynGaxeBw3gJeg8t4Zcq9L_6YIe5O0YEzfYKzt_0E3f_4fre8qtY_V9fLi3Vlm7bOFTNESS7BSNlwZpizlnekpow5w7pOSrUByV2rlLNcGcH4xknTOCVMy7mwzQn6Os99juHXBCnrwScLfW9GCFPSVIoSmmoFK-iXf9CnMMWx_K5QikhK6rotFJ0pG0NKEZx-jn4wcacp0fsa9FyDLunqfQ2aF8_nt8nTZoDur-NP7gWoZyAVaXyE-O7p_079DZOwkqs</recordid><startdate>20170501</startdate><enddate>20170501</enddate><creator>Sato, Takafumi</creator><creator>Inoue, Yosuke</creator><creator>Takahashi, Yu</creator><creator>Mise, Yoshihiro</creator><creator>Ishizawa, Takeaki</creator><creator>Tanakura, Kenta</creator><creator>Ito, Hiromichi</creator><creator>Saiura, Akio</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20170501</creationdate><title>Distal Pancreatectomy with Celiac Axis Resection Combined with Reconstruction of the Left Gastric Artery</title><author>Sato, Takafumi ; 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However, ischemic complications such as ischemic gastropathy and liver failure are problematic. To avoid these complications, we developed left gastric artery-reconstructing distal pancreatectomy with celiac axis resection. We used the middle colic artery for reconstruction. We performed this procedure in 10 patients, using the middle colic artery in three different ways: left branch reconstruction, right branch reconstruction, and reverse reconstruction. On postoperative images, 90% of the reconstructed left gastric arteries were patent. No complications associated with arterial reconstruction occurred. No patients developed ischemic gastropathy or liver failure. The R0 resection rate was 70%. Nine patients underwent adjuvant chemotherapy and seven patients were able to start it within 90 days. Distal pancreatectomy with celiac axis resection combined with reconstruction of the left gastric artery using the middle colic artery is a feasible option and would enhance the safety for carefully selected patients. Multicenter validation is needed to clarify the benefits of this new procedure.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>28116666</pmid><doi>10.1007/s11605-017-3366-5</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Aged Cancer research Cancer therapies Carcinoma, Pancreatic Ductal - surgery Celiac Artery - surgery Chemotherapy Dissection Female Fistula Gastroenterology Hepatic Artery - surgery How I do it Humans Ischemia Male Medical prognosis Medical research Medicine Medicine & Public Health Mesenteric Artery, Superior - surgery Middle Aged Pancreatectomy - methods Pancreatic cancer Pancreatic Neoplasms - surgery Plastic Surgery Procedures - methods Stomach - blood supply Surgery Surgical outcomes Vascular Surgical Procedures - methods Veins & arteries |
| title | Distal Pancreatectomy with Celiac Axis Resection Combined with Reconstruction of the Left Gastric Artery |
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