Zentralblatt fur Chirurgie · 2016
[Laparoscopic Division of the Arcuate Ligament: Treatment of the Coeliac Artery Compression Syndrome].
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Ellebrecht D B, Jung C F M, Hoffmann M, Keck T
Аннотация
Objective: The coeliac artery compression syndrome, first described by Harjola und Dunbar, results from the coeliac artery and plexus being compressed by the arcuate ligament at their origin. The clinical symptoms are postprandial pain and weight loss and the syndrome significantly restricts patients' quality of life. In rare cases, an epigastric bruit is detected on clinical examination. Laparoscopic division of the arcuate ligament is a successful option for the treatment of the coeliac artery compression syndrome. Indications: Laparoscopic decompression is indicated for patients with a symptom triad of postprandial pain, weight loss and epigastric bruit and radiologic confirmation of coeliac artery compression by duplex sonography, computed tomography angiography or magnetic resonance angiography. Procedure: The operative strategy is based on the division of the arcuate ligament following its visualisation above the origin of the coeliac artery from the abdominal aorta. Conclusion: The laparoscopic division of the arcuate ligament and the resection of the coeliac plexus are a largely uneventful, minimally-invasive option to treat the coeliac artery compression syndrome and restore patients' quality of life.