{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:32:07Z","timestamp":1776299527674,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T00:00:00Z","timestamp":1746316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T00:00:00Z","timestamp":1746316800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pancreatic cancer with arterial involvement has been traditionally considered unresectable. However, recent advances in multimodal therapy and surgical techniques have made radical resection possible in selected cases. This study aimed to evaluate arterial patency rates and clinical outcomes from short\u2010 to long\u2010term follow\u2010up in patients who underwent distal pancreatectomy with celiac axis resection (DP\u2010CAR) and reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was conducted on patients who underwent DP\u2010CAR from 2006 to 2022. The primary outcomes were ischemic complications and arterial patency rates. Secondary outcomes included perioperative complications and survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 620 pancreatic resections, 30 patients underwent DP\u2010CAR. Fifteen patients underwent arterial reconstruction, primarily using the middle colic artery (MCA). Severe complications occurred in 8 patients (26.7%), with zero 90\u2010day mortality. Ischemic gastropathy occurred in 3\/8 patients (37.5%) without LGA reconstruction but in none of the reconstruction group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.032). Among 15 LGA reconstructions, 6 cases (40%) maintained patency throughout follow\u2010up, with a median patency duration of 2.3\u00a0months for all reconstruction cases and 25.1\u00a0months for cases with maintained patency. All arterial occlusions occurred within 4\u00a0months postoperatively without adverse events. Gallbladder ischemia was observed in 2\/7 patients (28.6%) with LGA reconstruction but in none without reconstruction. No hepatic ischemia was observed in either group. The median overall survival from initial treatment was 50.4\u00a0months, with a 5\u2010year survival rate of 43.7%. The R0 resection rate was 90.0%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DP\u2010CAR with arterial reconstruction can be safely performed in selected patients, achieving favorable long\u2010term outcomes. LGA reconstruction appears crucial in preventing ischemic gastropathy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.12603","type":"journal-article","created":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T22:59:46Z","timestamp":1746399586000},"page":"1555-1563","source":"Crossref","is-referenced-by-count":1,"title":["Left Gastric Artery Reconstruction Using Middle Colic Artery in Distal Pancreatectomy With Celiac Axis Resection: Impact on Ischemic Complications and Long\u2010Term Outcomes"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2102-1276","authenticated-orcid":false,"given":"Minako","family":"Nagai","sequence":"first","affiliation":[{"name":"Department of Surgery Nara Medical University  Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Nara Medical University  Nara 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