scholarly journals Left gastric artery to Aortic anastomosis for the management of Coeliac Artery Stenosis during pancreaticoduodenectomy

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S302
Author(s):  
V. Shanmugam ◽  
S. Balakrishnan ◽  
S. Kapoor ◽  
P. Vaijyanath ◽  
H. Singh
Keyword(s):  
Left Gastric Artery ◽  
Artery Stenosis ◽  
Gastric Artery ◽  
Coeliac Artery ◽  
Aortic Anastomosis

scholarly journals An innovative way of managing coeliac artery stenosis during pancreaticoduodenectomy

2018 ◽  
Vol 100 (7) ◽  
pp. e168-e170
Author(s):  
S Balakrishnan ◽  
S Kapoor ◽  
P Vijayanath ◽  
H Singh ◽  
A Nandhakumar ◽  
...  
Keyword(s):  
Pancreatic Head ◽  
Left Gastric Artery ◽  
Artery Stenosis ◽  
Uneventful Recovery ◽  
Reconstruction Technique ◽  
Median Arcuate Ligament ◽  
Coeliac Artery ◽  
Arcuate Ligament ◽  
History Of ◽  
Additional Procedure

Coeliac artery stenosis (CAS) is rarely of consequence owing to rich collateral supply from the superior mesenteric artery via the pancreatic head. Pancreaticoduodenectomy (PD) in CAS disrupts these collaterals, and places the liver, stomach and spleen at risk of ischaemia. A 56-year-old man presented with a 3-week history of obstructive jaundice. Computed tomography revealed an operable periampullary tumour with CAS due to compression by the median arcuate ligament with multiple collaterals in the pancreatic head and a prominent gastroduodenal artery (GDA). Following unsuccessful coeliac axis endovascular stenting, a PD was performed. Intraoperative median arcuate ligament release failed to restore good flow in the common hepatic artery (CHA) and splenic artery (SpA) A decision was made to use the left gastric artery (LGA) for arterial reconstruction, disconnect it from the stomach with its origin intact and anastomose it to the supracoeliac aorta. Doppler ultrasonography with a GDA clamp confirmed good filling of the CHA and SpA via the LGA. The GDA was ligated and the PD completed. The patient had an uneventful recovery except for a biochemical pancreatic leak and was discharged on day 10. CAS during PD (confirmed by a decrease in CHA flow with a GDA clamp) requires an additional procedure to restore blood flow to the liver, stomach and spleen. Anastomosing the LGA to the supracoeliac aorta is a simple reconstruction technique for achieving this.

Transcatheter Chemoembolization of a Hepatocellular Carcinoma Utilizing Lipiodol through the Pancreaticoduodenal Arcade: A Case Report

2018 ◽  
Vol 2 ◽  
pp. 5
Author(s):  
Scott P Patterson ◽  
Richard G Foster
Keyword(s):  
Hepatocellular Carcinoma ◽  
Case Report ◽  
Vascular Anatomy ◽  
Left Gastric Artery ◽  
Target Lesion ◽  
Celiac Artery ◽  
Small Hepatocellular Carcinoma ◽  
Gastric Artery ◽  
Variant Anatomy ◽  
Pancreaticoduodenal Arcade

This case report describes the chemoembolization of a small hepatocellular carcinoma employing a lipiodol drug delivery system utilizing a novel arterial pathway. Because the target lesion was precariously located adjacent to the inferior heart border and the diaphragm, it was unsuitable for imaging-guided microwave ablation. To achieve chemoembolization, several intraprocedural adaptations were necessary, given the variant anatomy encountered and difficulty accessing the left gastric artery through a celiac artery approach. The left gastric artery was selected from a superior mesenteric artery approach through the pancreaticoduodenal arcade (Rio Branco’s arcade). This case illustrates the importance of a mastery of the vascular anatomy and variants of hepatic arterial flow.

scholarly journals Prognostic impact of lymph node metastasis along the left gastric artery in esophageal squamous cell carcinoma

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xuan Liu ◽  
Leilei Wu ◽  
Dongkun Zhang ◽  
Peng Lin ◽  
Hao Long ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Regression ◽  
Left Gastric Artery ◽  
Prognostic Impact ◽  
Gastric Artery ◽  
Term Survival

Abstract Background Although the incidence of lymph node (LN) metastasis (LNM) along the left gastric artery is high, its relationship with the prognosis in postoperative patients with esophageal squamous cell carcinoma (ESCC) is rarely reported. This study clarified the prognostic impact of LNM along the left gastric artery in postoperative patients with ESCC. Methods This study assessed data of 1521 patients with ESCC who underwent esophagectomy at the Sun Yat-sen University Cancer Center between March 1992 and March 2012. A chi-squared test and Mann-Whitney U test were used to explore the preliminary correlation between clinical factors and LNM along the left gastric artery. Univariate and multivariate Cox regression analyses were used to assess whether LNM along the left gastric artery was an independent predictor of overall survival. Kaplan–Meier analysis and the log-rank test were used to present a classifying effect based on LN status. Results LNM was observed in 598 patients (39.3%) and was found along the branches of the left gastric artery in 256 patients (16.8%). The patients were classified into two groups based on the presence of LNM along the left gastric artery. Patients without LNM along the left gastric artery had better cancer-specific survival than those with positive LNs (P <  0.001). Conclusions This study indicated that LNM along the left gastric artery was an important independent prognostic factor for long-term survival among ESCC patients (P = 0.011).

scholarly journals Hemorrhagic Gastric Metastasis from Hepatocellular Carcinoma Successfully Treated Using Coil Embolization of the Left Gastric Artery

2019 ◽  
Vol 58 (15) ◽  
pp. 2179-2183
Author(s):  
Michitaka Imai ◽  
Toru Ishikawa ◽  
Marina Okoshi ◽  
Kei Tomiyoshi ◽  
Yuichi Kojima ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Coil Embolization ◽  
Left Gastric Artery ◽  
Gastric Artery ◽  
Gastric Metastasis

scholarly journals The Features of Extrahepatic Collateral Arteries Related to Hepatic Artery Occlusion and Benefits in the Transarterial Management of Liver Tumors

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Lin Yang ◽  
Xiao Ming Zhang ◽  
Yong Jun Ren ◽  
Nan Dong Miao ◽  
Xiao Hua Huang ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Liver Tumors ◽  
Left Gastric Artery ◽  
Artery Occlusion ◽  
Gastric Artery ◽  
Collateral Arteries ◽  
Hepatocellular Carcinomas ◽  
Collateral Artery ◽  
The Common ◽  
The One

Purpose. To investigate the extrahepatic collateral arteries related to hepatic artery occlusion (HAO) and to determine its benefits in the transarterial management of liver tumors.Methods and Findings. Eleven patients (7 hepatocellular carcinomas, 3 liver metastases, and 1 with hemangioma) with HAO confirmed with digital subtraction angiography (DSA) were admitted to our hospital. Of the 11 patients, 7 were men and 4 were women, with an average age of 41.5 ± 15.5 years (range: 29 to 70 years). DSA was performed to evaluate the collateral routes to the liver. In the 11 patients with HAO, DSA showed complete occlusion of the common hepatic artery in 9 patients and the proper hepatic artery (PHA) in 2 patients. Extrahepatic collateral arteries supplying the liver were readily evident. The collateral arteries originated from the superior mesenteric artery (SMA) in 8 patients, from the gastroduodenal artery in 2 patients, and from the left gastric artery (LGA) in 1 patient. Transcatheter treatment was successfully performed via the collateral artery in all patients except the one who had hemangioma.Conclusions. DSA is an effective method for detecting collateral circulation related to HAO and may provide information to guide transcatheter management decisions.

Distal subtotal gastrectomy with preservation of the left gastric artery and vagal branches

2003 ◽  
Vol 185 (4) ◽  
pp. 395-396 ◽  
Author(s):  
Julian E. Losanoff ◽  
Bruce W. Richman ◽  
James W. Jones
Keyword(s):  
Subtotal Gastrectomy ◽  
Left Gastric Artery ◽  
Gastric Artery

Left gastric artery pseudoaneurysm mimicking a giant gastric subepithelial lesion

2021 ◽  
Author(s):  
Hung-Yi Chen ◽  
Hsing-Hao Ho ◽  
De-Chuan Chan ◽  
Peng-Jen Chen ◽  
Jung-Chun Lin
Keyword(s):  
Left Gastric Artery ◽  
Gastric Artery ◽  
Artery Pseudoaneurysm ◽  
Subepithelial Lesion

scholarly journals Arterial diameter of the celiac trunk and its branches: anatomical study

2009 ◽  
Vol 24 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Luís Augusto da Silveira ◽  
Fernando Braga Cassiano Silveira ◽  
Valéria Paula Sassoli Fazan
Keyword(s):  
Hepatic Artery ◽  
Celiac Trunk ◽  
Anatomical Study ◽  
Anatomical Variations ◽  
Left Gastric Artery ◽  
Gastric Artery ◽  
Arterial Diameter ◽  
Significant Difference ◽  
Diameter Reduction ◽  
Formalin Fixed

PURPOSE: Despite the fact that anatomical variations of the celiac trunk are well explored in the literature, information on these vessels diameters is scanty. The aims of the present study were to describe the arterial diameters of the celiac trunk and its main branches, and to investigate if these diameters are altered in those cases presenting anatomical variations of these vessels. METHODS: Twenty-one formalin fixed adult male cadavers were appropriately dissected for the celiac trunk identification and arterial diameter measurements. Arteries measured included the celiac trunk and its main branches (splenic artery, left gastric artery and common hepatic artery), as the proper hepatic artery, right gastric artery, the left and right hepatic arteries and the gastroduodenal artery. RESULTS: From the 21 cadavers, 6 presented anatomical variations of, at least, one of the above mentioned branches. The average arterial diameter comparisons between groups (normal and variable) clearly showed smaller diameters for variable vessels, but with no significant difference. CONCLUSION: Our data indicates the possibility of a diameter reduction of the celiac trunk main branches in the presence of anatomical variations. This should be taken into account on the selection for the liver transplantation donors.

Distal Pancreatectomy with Celiac Axis Resection Combined with Reconstruction of the Left Gastric Artery

2017 ◽  
Vol 21 (5) ◽  
pp. 910-917 ◽  
Author(s):  
Takafumi Sato ◽  
Yosuke Inoue ◽  
Yu Takahashi ◽  
Yoshihiro Mise ◽  
Takeaki Ishizawa ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Left Gastric Artery ◽  
Celiac Axis ◽  
Gastric Artery
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