Extravasal compression of the celiac trunk is the cause of chronic abdominal ischemia syndrome (CAI) along with atherosclerotic lesions of the visceral branches of the aorta. Patients with isolated compression are distinguished, and patients belonging to the older age group with compression in combination with atherosclerotic lesions. Currently, the issues of indications for surgical treatment, the nature and technique of surgical intervention, as well as the assessment of the results of decompression in the early and late postoperative periods remain controversial and unresolved.

Results of treatment of patients with extravasal compression of the celiac trunk and its atherosclerotic lesion

SOUTH. starkov, e-mail: [email protected], A.V. Pokrovsky, S.V. Dzhantukhanov, I.E. Timina, A.F. Kharazov, R. D. Zamolodchikov, N. Yu. Glagoleva

National Medical Research Center for Surgery. A.V. Vishnevsky

Introduction. Extravasal compression of the celiac trunk is the cause of chronic abdominal ischemia syndrome (CAI) along with atherosclerotic lesions of the visceral branches of the aorta. Patients with isolated compression are distinguished, and patients belonging to the older age group with compression in combination with atherosclerotic lesions. Currently, the issues of indications for surgical treatment, the nature and technique of surgical intervention, as well as the assessment of the results of decompression in the early and late postoperative periods remain controversial and unresolved.

Target. The aim of our study was to determine the indications and contraindications for surgical intervention, improve the surgical technique, evaluate and search for ways to improve the immediate and long-term results of laparoscopic decompression of the celiac trunk.

Materials and methods. The article discusses the experience of performing 27 laparoscopic decompressions of the celiac trunk and the results of examination and treatment of 5 patients who underwent endovascular interventions for a combined lesion – extravasal compression of the celiac trunk and atherosclerotic occlusion. Intraoperative laparoscopic ultrasound was performed in all cases of celiac trunk decompression to determine the topography of the celiac trunk and assess the adequacy of its decompression.

results. The average duration of the operation was 92 minutes. There were no intraoperative complications and complications in the early postoperative period. Intraoperative blood loss did not exceed 50 ml. The average length of stay in the hospital was 5 days. According to ultrasound data, the average degree of narrowing of the celiac trunk before surgery was 76%, in the early postoperative period it decreased to 43%, and in the long-term period it decreased to 32%.

Discussion. Based on our experience, the key to the successful maintenance of patients with the syndrome of the compression of the ventilation trunk is a multidisciplinary approach to diagnosis and treatment. Patients need careful differential diagnosis, including the consultation of the psychoneurologist. The experience of treating patients having an atherosclerotic lesion of the hubbar in combination with extravasive compression showed good nearest and long-term results of decompression and adverse results performed by the first stage of endovascular interventions.

Conclusion. Laparoscopic decompression of the ventricular trunk is an effective treatment for patients who do not have atherosclerotic lesions.

For citation: Starkov Yu.G., Pokrovsky A.V., Jantukhanova S.V., Timin I.E., Harazov A.F., Zavalodchikov R.D., Glagoleva N.Yu. The results of the treatment of patients with the extravasory compression of the crust and atherosclerotic lesion. Atherotrombosis. 2020; (1): 104-115. https://doi.org/10.21518/2307-1109-2020-1-104-115

Conflict of interest: The authors declare the lack of conflict of interest.

Treatment Results in Patients with Extravasal Compression of Celiac Trunk and Its Atherosclerotic Lesion

Yuriy G. Starkov., e-mail: [email protected], Anatoliy V. Pokrovskiy., Seda V. Dzhantukhanova., Nadezhda Yu. Glaguoleva., Irina E. Timina., Aleksandr F. Kharazov.,
Rodion D. Zamolodchikov.

A.V. Vishnevsky National Medical Research Institute of Surgery

Introduction. Extravasal Compression of Celiac Tunk Is the Cause of Chronic Abdominal Ischemia Syndrome (Cais) Along With Atherosclerotic Lesions of the Visceral Branches of the Aorta. PATIENTS WITH ISOLATED COMPRESSION AND THOSE IN THE OLDER AGE GROUP WITH COMPRESSION COMBINED WITH ATEROSCLEROTIC LESION ARE DISTINGUISHED AT PRESENT, THE ISSUES OF INDICATIONS FOR SURGICAL TREATMENT, THE PATTERN AND TECHNIQUE OF SURGICAL INTERVENTION AS WELL AS THE EVALUATION OF DISTANT POSTOPERES IN THE EARLY AND DISTANT POSTOPEROVERATIVE PERIOD REMAIN CONTROVERSIAL AND UNSOLVED. AIM. The Aim of Our Study Was To Determine Indications and Contraindications for Surgical Intervention, To Improve The Technique of the Surgery, To Evaluate and Find Ways to Improve The Closest and Most Distant Results of Laparoscopic DECOMPRESSION OF THE CELIAC TRUNK.

Materials and Methods. The article discusses the experience of performing 27 laparoscopic decompressions of the celiac trunk and the results of examination and treatment of 5 patients who underwent endovascular interventions due to a combined lesion – extravasal compression of the celiac trunk and atherosclerotic occlusion. Intraoperative Laparoscopic Ultrasound Was Performed in All Cases of the Celiac Trunk Decompression to Determine The Celiac Trunk TOPOGRAPHY AND ASSESSON THE ADEQUACY OF ITS DECOMPRESSION

RESULTS.The Average Duration of the Surgery Was 92 Minutes. Intraoperative and Early Postoperative Complications Were Not Observed. Intraoperative Blood Loss Didn't Exceed 50 ML. Average Duration of Stay in the Hospital Was 5 Days. According to the date of Ultrasound Examination, The Average Degree of Celiac Trunk Compression Before Operation WAS 76%, In The Early Postoperative Period It Decreased to 43%, and in the distant period it decreased to 32%.

Discussion.. Based on Our Experience, The Key To Successful Management of Patients with Celiac Trunk Compression Syndrome Is A Multidisciplinary Approach to Diagnosis and Treatment. Patients Need Thorough Differential Diagnosis, Including Psychoneurologist Consultation. Experience In Treating Patients WITH ATHEROSCLEROTIC LESIONS OF THE CELIAC TRUNK COMBINED WITH EXTRAVASAL COMPRESSION HAS SHOWN GOOD IMMEDIATE AND DISTANT DECOMPRESSION RESULTS AND ADVERSE RESULTS OF THE FIRST STAGE OF ENDOVASCULAR INTERVENTIONS.

Conclusions. Laparoscopic DECOMPRESSION OF THE CELIAC TRUNK IS AN EFFECTVE TREATMENT METHOD IN PATIENTS WITHOUT ATEROSCLEROTIC LESIONS.

For citation: Starkov Y.G., Pokrovskiy A.V., DZHANTUKHANOVA S.V., Timina I.E., Kharazov A.F., Zamolodchikov R.D., Glagoleva N.Yu. Treatment Results in Patients with Extravasal Compression of Celiac Trunk and Its Atherosclerotic Lesion. Atherothrombosis. 2020; (1): 104-115. (In russ.) Https://doi.org/10.21518/2307-1109-2020-1-104-115

Conflict of Interest: The AUTHORS DECLARE THAT THERE IS NO Conflict of Interest.