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Related Experiment Video

Updated: Jun 22, 2026

Robot Assisted Distal Pancreatectomy with Celiac Axis Resection (DP-CAR) for Pancreatic Cancer: Surgical Planning and Technique
13:56

Robot Assisted Distal Pancreatectomy with Celiac Axis Resection (DP-CAR) for Pancreatic Cancer: Surgical Planning and Technique

Published on: August 14, 2021

Celiac artery compression syndrome managed by laparoscopy.

Paolo Baccari1, Efrem Civilini, Laura Dordoni

  • 1Department of General Surgery, Scientific Institute San Raffaele University Hospital, Milan, Italy. paolo.baccari@hsr.it

Journal of Vascular Surgery
|July 1, 2009
PubMed
Summary

Laparoscopic surgery for celiac artery compression syndrome (CACS) is safe and effective for relieving stenosis. This minimally invasive approach offers successful symptom resolution for most patients with CACS.

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Last Updated: Jun 22, 2026

Robot Assisted Distal Pancreatectomy with Celiac Axis Resection (DP-CAR) for Pancreatic Cancer: Surgical Planning and Technique
13:56

Robot Assisted Distal Pancreatectomy with Celiac Axis Resection (DP-CAR) for Pancreatic Cancer: Surgical Planning and Technique

Published on: August 14, 2021

Area of Science:

  • Vascular Surgery
  • Minimally Invasive Surgery
  • Gastroenterology

Background:

  • Celiac artery compression syndrome (CACS) results from extrinsic compression of the celiac trunk, often due to the median arcuate ligament.
  • Surgical decompression by dividing the median arcuate ligament is a primary treatment.
  • Laparoscopic techniques offer a minimally invasive alternative for CACS management.

Purpose of the Study:

  • To evaluate the feasibility, safety, and efficacy of a laparoscopic approach for managing CACS.
  • To report a 7-year experience with laparoscopic treatment of CACS caused by median arcuate ligament compression.

Main Methods:

  • A retrospective review of 16 patients (5 male, mean age 52) treated between July 2001 and May 2008.
  • Diagnosis confirmed via duplex ultrasound and CT/MR angiography.
  • Laparoscopic division of the median arcuate ligament and skeletonization of the celiac trunk.

Main Results:

  • All 16 patients underwent successful laparoscopic procedures with celiac trunk skeletonization.
  • Mean operative time was 90 minutes; two conversions to open surgery due to bleeding.
  • 14 patients remained asymptomatic postoperatively; mean follow-up of 28.3 months.
  • One patient required bypass grafting for restenosis; another underwent PTA and stenting post-laparoscopy.

Conclusions:

  • Laparoscopic management of CACS is feasible, safe, and successful when performed by experienced surgeons.
  • Percutaneous transluminal angioplasty (PTA) and stenting can be a useful adjunct after surgical decompression.
  • Further studies with longer follow-up are warranted to confirm long-term outcomes.