Celiac compression syndrome: tailored therapy based on intraoperative findings

Area of Science:

• Vascular Surgery
• Gastroenterology
• Surgical Innovation

Background:

• Celiac artery compression syndrome (CACS) surgical treatment remains controversial.
• A tailored operative strategy based on intraoperative findings was employed.
• This study reviews outcomes of seven patients with CACS.

Purpose of the Study:

• To evaluate the efficacy of a tailored surgical approach for CACS.
• To determine if intraoperative findings can guide treatment decisions.
• To assess long-term symptom relief after intervention.

Main Methods:

• Retrospective review of seven patients with CACS undergoing tailored surgery over 15 years.
• Surgical intervention included celiac axis decompression via median arcuate ligament division and sympathetic nerve division.
• Revascularization procedures (e.g., bypass, angioplasty, reimplantation) were performed when intraoperative flow was compromised.

Main Results:

• All seven patients achieved complete symptom relief, both immediately and long-term.
• Decompression was performed in all cases; revascularization was necessary in five.
• Specific revascularization techniques included aortoceliac bypass, angioplasty, and aortic reimplantation.

Conclusions:

• A tailored surgical approach for CACS, guided by intraoperative assessment, is highly effective.
• This individualized strategy offers excellent prospects for immediate and sustained symptom freedom.
• The findings support the use of tailored operative interventions for CACS management.