Retrograde open celiac stenting for ischemic hepatitis after pancreaticoduodenectomy

Authors

Roberto G. Aru, Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, Baltimore, MD.
Sarah E. Deery, Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland, ME.Follow
Yasaman Kavousi, Division of Vascular Surgery, Henry Ford Hospital, Detroit, MI.
James H. Black, Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, Baltimore, MD.
William R. Burns, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Caitlin W. Hicks, Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine, Baltimore, MD.

Document Type

Article

Publication Date

3-4-2023

Institution/Department

Surgery

Journal Title

Journal of vascular surgery cases and innovative techniques

Abstract

A 74-year-old man with pancreatic cancer had undergone pancreaticoduodenectomy and subsequently developed ischemic hepatitis secondary to high-grade celiac artery stenosis. Celiac antegrade stenting via brachial artery access was unsuccessful, and open antegrade bypass would have required takedown of the pancreatic and/or biliary anastomoses for adequate exposure. Retrograde open celiac stenting was, therefore, successfully performed via the gastroduodenal artery stump. His ischemic hepatitis resolved, and he was ultimately discharged with dual antiplatelet therapy. Computed tomography angiography at 6 months demonstrated a widely patent celiac stent. Retrograde open celiac stenting via the gastroduodenal artery stump is an alternative to open bypass for celiac revascularization not amenable to percutaneous antegrade stenting in patients who have undergone pancreaticoduodenectomy.

ISSN

2468-4287

First Page

101136

Recommended Citation

Aru RG, Deery SE, Kavousi Y, Black JH 3rd, Burns WR, Hicks CW. Retrograde open celiac stenting for ischemic hepatitis after pancreaticoduodenectomy. J Vasc Surg Cases Innov Tech. 2023;9(2):101136. Published 2023 Mar 4. doi:10.1016/j.jvscit.2023.101136