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Complications Associated with Celiac Artery Occlusion Following Pancreaticoduodenectomy (Whipple Procedure)

Description

Occlusion of the celiac artery may be tolerated if there is adequate collateral circulation, especially through the pancreatic artery. During pancreaticoduodenectomy the pancreatic artery is ligated, which can result in ischemia in organs supplied by the celiac artery.


 

Occlusion of the celiac artery may be due to:

(1) atherosclerosis

(2) thrombosis

(3) extrinsic compression

(4) congenital

(5) iatrogenic

 

Complications associated with hypoperfusion through the celiac artery include:

(1) acute hepatic ischemia with marked elevation of serum AST and ALT

(2) gastric ischemia

 

If the problem is identified in advance or during surgery then revascularization or stenting can be performed during surgery. If the problem is suspected and identified after surgery then revascularization can be performed. If it is not suspected and not anticipated then it may go undetected, resulting in significant morbidity and mortality.

 


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