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Estenosis del tronco celíaco en pancreatoduodenectomía: predictores preoperatorios de intervención considerando la
Yuya Miura1, Ryo Ashida2, Katsuhisa Ohgi1
1Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
Annals of surgical oncology
|February 5, 2026
Resumen
La estenosis del tronco celíaco (ETC) en pacientes con pancreatoduodenectomía puede predecirse mediante cuatro factores clave. Estos predictores ayudan a los cirujanos a determinar cuándo es necesaria la intervención, mejorando la atención al paciente.
Área de la Ciencia:
- Cirugía Vascular; Oncología Quirúrgica; Radiología
Sus antecedentes:
- La estenosis del tronco celíaco (ETC) es una preocupación en la pancreatoduodenectomía. Los criterios de intervención para la ETC no están claros. La división de la circulación celíaca durante la cirugía presenta riesgos.
Objetivo del estudio:
- Identificar predictores fiables de intervención intraoperatoria para la estenosis del tronco celíaco (ETC). Evaluar marcadores basados en TC para valorar la gravedad de la ETC y la colateralización. Ayudar en la planificación preoperatoria para pacientes con ETC sometidos a pancreatoduodenectomía.
Principales métodos:
- Análisis retrospectivo de 1.042 pacientes sometidos a pancreatoduodenectomía. Medición preoperatoria mediante TC de la tasa de estenosis del tronco celíaco (SR). Cuantificación de la relación gastroduodenal-hepática común (GDA/CHA) y el diámetro de la arteria colateral.
Principales resultados:
- El 8,2% de los pacientes presentaron estenosis del tronco celíaco (ETC) (tasa de estenosis [SR] ≥50%); solo el 1,1% requirió intervención. Cuatro factores (diámetro de la estenosis ≤2 mm, SR ≥70%, relación de la arteria gastroduodenal/arteria hepática común [GDA/CHA] ≥1,0, diámetro de la arteria colateral ≥3 mm) predijeron la necesidad de intervención. Los pacientes con tres o más factores requirieron consistentemente intervención.
Conclusiones:
- Cuatro factores derivados de la TC predicen de forma fiable la necesidad de intervención para la ETC. Estos predictores pueden guiar la planificación quirúrgica preoperatoria. Una planificación informada garantiza que los recursos necesarios estén disponibles para la intervención.
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