Early ligation of the inferior pancreaticoduodenal artery to reduce blood loss during pancreaticoduodenectomy.

When performing a pancreaticoduodenectomy, a considerable amount of congested blood is lost, especially during the period when the pancreatic head area is being isolated from the superior mesenteric vessels. Following Kocher's maneuver, a 4-cm dissection was continued along the right margin of the superior mesenteric artery. The root of the inferior pancreaticoduodenal artery was disclosed and ligated prior to the following resection procedures. The early ligation of the inferior pangreaticoduodenal artery decreased blood loss (from 194+/-24 mL to 86+/-50 mL) during the period when the pancreatic head area was isolated from the superior mesenteric vessels. This approach was feasible in reducing blood loss presumably related to blood congestion.