Preoperative assessment of perigastric vascular anatomy by multidetector computed tomography angiogram for laparoscopy-assisted gastrectomy

Miyaki, Akira; Imamura, Kazuhiro; Kobayashi, Rie; Takami, Makoto; Matsumoto, Jun; Takada, Yukari

doi:10.1007/s00423-012-0956-2

Cited by 29 publications

(17 citation statements)

References 18 publications

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“…Recent advances in laparoscopic gastrectomy have allowed for a better understanding of LGV variations to ensure sufficient lymph node dissection for cancer and to prevent unnecessary bleeding . Several studies have demonstrated the precise determination and classification of the branching pattern of the LGV . Wu et al reported that the LGV flowed into the PV trunk in 45%, the SMV and SpV junction in 21% and the SpV in 33% based on MD‐CT imaging findings in 825 adults.…”

Section: Discussionmentioning

confidence: 99%

Novel technique for pediatric living donor liver transplantation in patients with portal vein obstruction: The “pullout technique”

Kasahara

Sasaki

Uchida

et al. 2018

Pediatric Transplantation

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PV hypoplasia may increase the risk of posttransplant complications, especially when it extends to near the SMV and SpV junction. We described our experience of 10 pediatric cases of PV hypoplasia/thrombus in which the pullout technique was required for PV reconstruction. There were five male and five female patients. The median age was 9 months, and the median weight was 8.1 kg. The indications for the pullout technique were PV hypoplasia in seven patients and PV thrombus in 3. The inflow sites of the enlarged LGV were as follows: the main PV trunk (n = 2), the SMV and SpV junction (n = 4), and the SpV (n = 4). The posterior face of the pancreas was tunneled along the PV, and the PV was returned to its original position with or without the use of an interposed vein graft. The pullout technique created a good operative field, which allowed for the complete removal of the hypoplastic PV or thrombectomy with the safe use of various interposed vein grafts.

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Section: Discussionmentioning

confidence: 99%

Novel technique for pediatric living donor liver transplantation in patients with portal vein obstruction: The “pullout technique”

Kasahara

Sasaki

Uchida

et al. 2018

Pediatric Transplantation

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“…Meanwhile, celiac artery variation could significantly increase intraoperative blood loss, especially in those who lacked effective preoperative assessment of the abdominal artery. Perioperative bleeding could be decreased through preoperative CTA assessment of celiac artery imaging information [26] . Results of this study showed that the celiac artery variation significantly extended operation time and increased intraoperative blood loss and postoperative amount of drainage, and therefore was an important factor influencing successful implementation of D2 radical gastrectomy and postoperative recovery.…”

Section: Discussionmentioning

confidence: 99%

Study of celiac artery variations and related surgical techniques in gastric cancer

Huang¹,

Mu²,

Qin³

et al. 2015

WJG

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AIM:To investigate celiac artery variations in gastric cancer patients and the impact on gastric cancer surgery, and also to discuss the value of the ultrasonic knife in reducing the risk caused by celiac artery variations. METHODS:A retrospective analysis was conducted to investigate the difference in average operation time, intraoperative blood loss, number of harvested lymph nodes, average postoperative drainage within 3 d, and postoperative hospital stay between the group with vascular variations and no vascular variations, and between the ultrasonic harmonic scalpel and conventional electric scalpel surgery group. RESULTS:One hundred and fifty-eight cases presented with normal celiac artery, and 80 presented with celiac artery variation (33.61%). The average operation time, blood loss, average drainage within 3 d after surgery in the celiac artery variation group were significantly more than in the no celiac artery variation group (215.7 ± 32.7 min vs 204.2 ± 31.3 min, 220.0 ± 56.7 mL vs 163.1 ± 52.3 mL, 193.6 ± 41.4 mL vs 175.3 ± 34.1 mL, respectively, P < 0.05). In celiac artery variation patients, the average operation time, blood loss, average drainage within 3 d after surgery in the ultrasonic harmonic scalpel group were significantly lower than in the conventional electric scalpel surgery group (209.5 ± 34.9 min vs 226.9 ± 29.4 min, 207.5 ± 57.1 mL vs 235.6 ± 52.9 mL, 184.4 ± 38.2 mL vs 205.0 ± 42.9 mL, respectively, P < 0.05), and the number of lymph node dissections was significantly higher than in the conventional surgery group (25.5 ± 9.2 vs 19.9 ± 7.8, P < 0.05). CONCLUSION: Celiac artery variation increases the ORIGINAL ARTICLE Study of celiac artery variations and related surgical techniques in gastric cancerand the effect of vascular variation on gastric cancer surgery outcome among 238 patients receiving radical gastrectomy, meanwhile addressing the efficacy of ultrasound harmonic scalpel in minimizing risk due to vascular variation, so as to provide a reference for guiding gastric cancer treatment in clinical practice. MATERIALS AND METHODS General informationTwo hundred and thirty-eight patients undergoing D2 radical gastrectomy by well experienced general surgeons in our department from January 2009 to May 2014 were included; the detailed information of tumor staging can be seen in Figure 1. All patients provided informed consent, and signed agreements. All the patients were preoperatively examined, through upper abdominal 64 multi-slice computed tomography angiography (MSCTA), to determine whether there was variation in the celiac trunk and its branches, wherein the abnormal hepatic artery was classified with reference to Hiatt's [4] classification. Inclusion and exclusion criteriaInclusion criteria: (1) preoperative pathology via gastroscopic biopsy indicated gastric cancer; (2) preoperative MSCTA was taken; (3) preoperative assessment showed indications for D2 radical surgery; (4) preoperative assessment showed no evident surgical contraindication; and (5) D2 or D2+ radical su...

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“…Anatomically, the vascular supply to the gastric fundus is predominantly and reliably from the left gastric artery ( Figure 5B ) and can be accessed with a catheter from a trans-arterial approach ( Figure 6 )( 43-45 ). Percutaneous trans-arterial embolization of the upper GI arteries for bleeding is a minimally-invasive procedure, which is routinely performed by interventional radiologists on both an in-patient and out-patient basis, and is generally well-tolerated given the rich collateral vascular supply to the GI tract.…”

Section: Bariatric Arterial Embolization: a New Approach To Treat Obementioning

confidence: 99%

Bariatric Embolization of the Gastric Arteries for the Treatment of Obesity

Weiss¹,

Gunn²,

Kim³

et al. 2015

Journal of Vascular and Interventional Radiology

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Obesity is a public health epidemic in the United States, which results in significant morbidity, mortality, and cost to the healthcare system. Despite advancements in therapeutic options for the bariatric patients, the number of overweight and obese individuals continues to rise. Thus, complimentary or alternative treatments to lifestyle changes and surgery are urgently needed. Embolization of the left gastric artery, or ‘bariatric arterial embolization’, has been shown to modulate body weight in animal models and early clinical studies. If successful, bariatric arterial embolization represents a potential minimally invasive approach to treat obesity offered by interventional radiologists. The purpose of the following review will be to introduce the interventional radiologist to bariatric arterial embolization by presenting its physiologic and anatomic bases, reviewing the pre-clinical and clinical data, and discussing current and future investigations.

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Preoperative assessment of perigastric vascular anatomy by multidetector computed tomography angiogram for laparoscopy-assisted gastrectomy

Abstract: An MDCT angiogram reconstructed using the MIP technique is effective for assessing the perigastric vascular anatomy before LAG for gastric cancer.

Cited by 29 publications

References 18 publications

Novel technique for pediatric living donor liver transplantation in patients with portal vein obstruction: The “pullout technique”

Novel technique for pediatric living donor liver transplantation in patients with portal vein obstruction: The “pullout technique”

Study of celiac artery variations and related surgical techniques in gastric cancer

Bariatric Embolization of the Gastric Arteries for the Treatment of Obesity

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