Original article Celiac artery stenosis and cephalic duodenopancreatectomy: An undervalued risk? José Muros, a Jordi Soriano, b Antonio Codina-Barreras, c Pere Planellas, c Santiago Lopez-Ben, c Maite Albiol, c Laia Falgueras, c Ernesto Castro, c Anna Pigem, c Albert Maroto, d Joan Figueras c,* a Servicio de Cirugía, Hospital de Getafe, Getafe, Madrid, Spain b IDI, Hospital Josep Trueta de Girona, IdIBGi, Girona, Spain c Servicio de Cirugía, Hospital Josep Trueta de Girona, IdIBGi, Girona, Spain d Servicio de Radiología, Hospital Josep Trueta de Girona, IdIBGi, Girona, Spain ARTICLE INFORMATION Article history: Received August 26, 2010 Accepted November 29, 2010 Keywords: Arterial stenosis Celiac artery/trunk Duodenopancreatectomy Pancreatic cancer Multidetector computed tomography Surgery Humans *Corresponding author. E-mail address: info@jfigueras.net (J. Figueras). 0009-739X/$ - see front matter © 2010 AEC. Published by Elsevier España, S.L. All rights reserved. ABSTRACT Introduction: Significant celiac trunk or artery stenosis (CAS) is normally asymptomatic. However, when the arteries of the pancreatoduodenal arcade are occluded, it could trigger a visceral ischaemia. The objective of this study is to determine whether preoperative CAS is a risk factor for developing complications in patients subjected to duodenopancreatectomy (DPC). Material and methods: We have retrospectively analysed 58 consecutive patients subjected to DPC. We have associated significant CAS with post-surgical outcome. In all cases a 16-channel multidetector computed tomography (MDCT) in three hepatic phases was performed. We have reviewed the pre-surgical MDCT focusing on the morphology of the celiac artery (CA), particularly in the presence or absence of significant stenosis (>50%). Results: We found CAS >50% in 13 patients (22%). The overall mortality was 5% (3 patients). Serious complications developed in 16 (28%) patients, 8 (62%) of whom belonged to the group with significant CAS (P=.004). Ten patients (17%) had a pancreatic fistula, 5 (38%) vs 5 (11%) (P=.036); Fourteen patients (24%) needed new surgery, 7 (54%) vs 7 (16%) (P=.009); Seven patients (12%) had a haemoperitoneum, 4 (31%) vs 3 (7%) (P=.038), in the group with and without CAS, respectively. Conclusions: Significant radiological CAS is a risk factor of serious complications after DPC. The study of the calibre of the superior mesenteric artery (SMA) with MDCT should be routine before a DPC. The correction of a significant CAS should be evaluated preoperatively.. © 2010 AEC. Published by Elsevier España, S.L. All rights reserved. Indexada en: Science Citation Index Expanded, Journal Citation Reports, Index Medicus/MEDLINE, Scopus, EMCare, Scirus, IBECS e IME Free English text available on-line www.elsevier.es/cirugia CIRUGÍA ESPAÑOLA ÓRGANO OFICIAL DE LA ASOCIACIÓN ESPAÑOLA DE CIRUJANOS Volumen 87, Número 2, Febrero 2010 Editorial Tratamiento antibiótico empírico de la infección intraabdominal Artículo especial Recomendaciones en el tratamiento antibiótico empírico de la infección intraabdominal Originales El trasplante hepático aumenta la resecabilidad R0 y la supervivencia de los pacientes con tumor de Klatskin irresecable no diseminado Desarrollo de un índice de capacidad estructural para hospitales de agudos con cirugía oncológica Desarrollo multidisciplinario de la cirugía robótica en un hospital universitario de tercer nivel: organización y resultados Factores de riesgo de mortalidad postoperatoria en el cáncer colorrectal: seguimiento de una cohorte en una unidad especializada Mucocele apendicular: presentación de 31 casos CIRUGÍA ESPAÑOLA www.elsevier.es/cirugia CIR ESP. 2011;89(4):230–236