Abstract
s / Pancreatology 13 (2013) S1–S80 S74 Background/aim: During a PD it is important to fully understand the arcade of blood vessels in the head of the pancreas before the surgery to reduce intraoperative bleeding. In most of our patients, the inferior pancreaticoduodenal artery (IPDA), one of the efferent arteries of the head of the pancreas, forms a short common trunkwith thefirst jejunal artery (FJA). There are twoways to locate the IPDA: tomeasure the distance between the origin of the superior mesenteric artery (SMA) and that of the FJA or to measure the distance between the origin of the middle colic artery (MCA) and that of the FJA. In this study, we measured both distances using 3D models of arteries constructed with MD-CT and discussed which distance can be more easily measured to help determine the location of the IPDA. Methods: One-hundred-forty patients underwent 64-MD-CT to acquire early and late arterial phase images. The distance between the SMA origin and the FJA origin and the distance between the MCA origin and the FJA origin were measured. Results: In patients whose IPDA formed a common trunk with the FJA or arose directly from the SMA, the IPDA or the common truck was located in parallel with the SMA at a very short distance of approximately 18 mm from theMCAorigin towards the center. The distance between the SMAorigin and the IPDAwas significantly longer. Therefore, locating the MCA origin during PD helped determine the location of the IPDA. Thus, locating the SMA origin was helped determine the location of the IPDA during PD in these patients. Conclusions: Considering that the distance between the IPDA origin and the MCA origin was short, it was demonstrated that it is effective to locate the MCA origin to determine the location of the PIPDA.
Published Version
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