An aberrant right hepatic artery arising from the gastroduodenal artery: a pitfall encountered during pancreaticoduodenectomy.
Adolescent
Adult
Aged
Aged, 80 and over
Child
Duodenum
/ blood supply
Female
Hepatic Artery
/ abnormalities
Humans
Intraoperative Complications
/ prevention & control
Ligation
Magnetic Resonance Imaging
Male
Middle Aged
Pancreaticoduodenectomy
/ methods
Perioperative Period
Stomach
/ blood supply
Tomography, X-Ray Computed
Ultrasonography, Doppler
Vascular System Injuries
/ prevention & control
Young Adult
Aberrant right hepatic artery
Pancreas
Pancreaticoduodenectomy
Journal
Surgery today
ISSN: 1436-2813
Titre abrégé: Surg Today
Pays: Japan
ID NLM: 9204360
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
03
08
2020
accepted:
13
01
2021
pubmed:
13
2
2021
medline:
29
12
2021
entrez:
12
2
2021
Statut:
ppublish
Résumé
Among the variations of the right hepatic artery (RHA), the identification of an aberrant RHA arising from the gastroduodenal artery (GDA) is vital for avoiding damage to the RHA during surgery, since ligation of the GDA is necessary during pancreaticoduodenectomy (PD). However, this variation is not frequently reported. The purpose of this study was to focus on an aberrant RHA arising from the GDA, which was not noted in the classifications reported by Michels and Hiatt. A total of 574 patients undergoing a PD between Jan 2001 and Dec 2015 at a tertiary care hospital in Switzerland (n = 366) and between Jan 2009 and May 2015 at a hospital in Japan (n = 208) were included in the analysis. Of these, preoperative CT angiography or/and MRI angiography findings were available for 532 patients. We retrospectively analyzed the hepatic artery variations, patient demographics, and surgical outcomes. Among the 532 patients who received a PD, an RHA originating from the GDA was observed in 19 cases (3.5%). Eleven patients (2.1%) had both an aberrant RHA and an aberrant left hepatic artery (LHA) (Hiatt Type 4). Six patients (1.2%) had a replaced CHA arising from the SMA (Hiatt Type 5). We could, therefore, correctly identify the aberration in all cases. We observed rarely reported but important aberrant RHA variations arising from the GDA. To prevent injury during PD in patients with this type of aberrant RHA, intensive preparations using CT and/or MRI imaging before surgery and intraoperative liver Doppler ultrasonography are considered to be essential.
Identifiants
pubmed: 33575949
doi: 10.1007/s00595-021-02242-4
pii: 10.1007/s00595-021-02242-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1577-1582Informations de copyright
© 2021. Springer Nature Singapore Pte Ltd.
Références
Bassi C, Falconi M, Salvia R, Mascetta G, Molinari E, Pederzoli P. Management of complications after pancreaticoduodenectomy in a high volume centre: results on 150 consecutive patients. Dig Surg. 2001;18(6):453–7 (discussion 8. PubMed PMID: 11799295).
doi: 10.1159/000050193
Yeo CJ, Cameron JL, Lillemoe KD, Sauter PK, Coleman J, Sohn TA, et al. Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? Results of a prospective randomized placebo-controlled trial. Ann Surg. 2000;232(3):419–29 (PubMed PMID: 10973392; PubMed Central PMCID: PMCPMC1421155).
doi: 10.1097/00000658-200009000-00014
de Castro SM, Busch OR, van Gulik TM, Obertop H, Gouma DJ. Incidence and management of pancreatic leakage after pancreatoduodenectomy. Br J Surg. 2005;92(9):1117–23. https://doi.org/10.1002/bjs.5047 (PubMed PMID: 15931656).
doi: 10.1002/bjs.5047
pubmed: 15931656
Yeo CJ, Cameron JL, Sohn TA, Lillemoe KD, Pitt HA, Talamini MA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg. 1997;226(3):248–57 ((discussion 57–60. PubMed PMID: 9339931; PubMed Central PMCID: PMCPMC1191017)).
doi: 10.1097/00000658-199709000-00004
van Heek NT, Kuhlmann KF, Scholten RJ, de Castro SM, Busch OR, van Gulik TM, et al. Hospital volume and mortality after pancreatic resection: a systematic review and an evaluation of intervention in the Netherlands. Ann Surg. 2005;242(6):781–8 ((discussion 8–90. PubMed PMID: 16327488; PubMed Central PMCID: PMCPMC1409869)).
doi: 10.1097/01.sla.0000188462.00249.36
Yang SH, Yin YH, Jang JY, Lee SE, Chung JW, Suh KS, et al. Assessment of hepatic arterial anatomy in keeping with preservation of the vasculature while performing pancreatoduodenectomy: an opinion. World J Surg. 2007;31(12):2384–91. https://doi.org/10.1007/s00268-007-9246-5 (PubMed PMID: 17922256).
doi: 10.1007/s00268-007-9246-5
pubmed: 17922256
Gaujoux S, Sauvanet A, Vullierme MP, Cortes A, Dokmak S, Sibert A, et al. Ischemic complications after pancreaticoduodenectomy: incidence, prevention, and management. Ann Surg. 2009;249(1):111–7. https://doi.org/10.1097/SLA.0b013e3181930249 (PubMed PMID: 19106685).
doi: 10.1097/SLA.0b013e3181930249
pubmed: 19106685
Biehl TR, Traverso LW, Hauptmann E, Ryan JA Jr. Preoperative visceral angiography alters intraoperative strategy during the Whipple procedure. Am J Surg. 1993;165(5):607–12 (PubMed PMID: 8098185).
doi: 10.1016/S0002-9610(05)80444-1
Michels NA. The hepatic, cystic and retroduodenal arteries and their relations to the biliary ducts with samples of the entire celiacal blood supply. Ann Surg. 1951;133(4):503–24 (PubMed PMID: 14819988; PubMed Central PMCID: PMCPMC1616853).
doi: 10.1097/00000658-195104000-00009
Hiatt JR, Gabbay J, Busuttil RW. Surgical anatomy of the hepatic arteries in 1000 cases. Ann Surg. 1994;220(1):50–2 (PubMed PMID: 8024358; PubMed Central PMCID: PMCPMC1234286).
doi: 10.1097/00000658-199407000-00008
Stauffer JA, Bridges MD, Turan N, Nguyen JH, Martin JK. Aberrant right hepatic arterial anatomy and pancreaticoduodenectomy: recognition, prevalence and management. HPB (Oxford). 2009;11(2):161–5. https://doi.org/10.1111/j.1477-2574.2009.00037.x (PubMedPMID:19590642;PubMedCentralPMCID:PMCPMC2697872).
doi: 10.1111/j.1477-2574.2009.00037.x
Lee JM, Lee YJ, Kim CW, Moon KM, Kim MW. Clinical implications of an aberrant right hepatic artery in patients undergoing pancreaticoduodenectomy. World J Surg. 2009;33(8):1727–32. https://doi.org/10.1007/s00268-009-0063-x (PubMed PMID: 19459000).
doi: 10.1007/s00268-009-0063-x
pubmed: 19459000
Eshuis WJ, Olde Loohuis KM, Busch OR, van Gulik TM, Gouma DJ. Influence of aberrant right hepatic artery on perioperative course and longterm survival after pancreatoduodenectomy. HPB (Oxford). 2011;13(3):161–7. https://doi.org/10.1111/j.1477-2574.2010.00258.x (PubMedPMID:21309932;PubMedCentralPMCID:PMCPMC3048966).
doi: 10.1111/j.1477-2574.2010.00258.x
Perwaiz A, Singh A, Singh T, Chaudhary A. Incidence and management of arterial anomalies in patients undergoing pancreaticoduodenectomy. JOP. 2010;11(1):25–30 (PubMed PMID: 20065548).
pubmed: 20065548
Jah A, Jamieson N, Huguet E, Praseedom R. The implications of the presence of an aberrant right hepatic artery in patients undergoing a pancreaticoduodenectomy. Surg Today. 2009;39(8):669–74. https://doi.org/10.1007/s00595-009-3947-3 (PubMed PMID: 19639433).
doi: 10.1007/s00595-009-3947-3
pubmed: 19639433
Turrini O, Wiebke EA, Delpero JR, Viret F, Lillemoe KD, Schmidt CM. Preservation of replaced or accessory right hepatic artery during pancreaticoduodenectomy for adenocarcinoma: impact on margin status and survival. J Gastrointest Surg. 2010;14(11):1813–9. https://doi.org/10.1007/s11605-010-1272-1 (PubMed PMID: 20697832).
doi: 10.1007/s11605-010-1272-1
pubmed: 20697832
Kim PT, Temple S, Atenafu EG, Cleary SP, Moulton CA, McGilvray ID, et al. Aberrant right hepatic artery in pancreaticoduodenectomy for adenocarcinoma: impact on resectability and postoperative outcomes. HPB (Oxford). 2014;16(3):204–11. https://doi.org/10.1111/hpb.12120 (PubMedPMID:23782313;PubMedCentralPMCID:PMCPMC3945845).
doi: 10.1111/hpb.12120
Rammohan A, Palaniappan R, Pitchaimuthu A, Rajendran K, Perumal SK, Balaraman K, et al. Implications of the presence of an aberrant right hepatic artery in patients undergoing pancreaticoduodenectomy. World J Gastrointest Surg. 2014;6(1):9–13. https://doi.org/10.4240/wjgs.v6.i1.9 (PubMedPMID:24627736;PubMedCentralPMCID:PMCPMC3951809).
doi: 10.4240/wjgs.v6.i1.9
pubmed: 24627736
pmcid: 3951809
Okada K, Kawai M, Hirono S, Miyazawa M, Shimizu A, Kitahata Y, et al. A replaced right hepatic artery adjacent to pancreatic carcinoma should be divided to obtain R0 resection in pancreaticoduodenectomy. Langenbecks Arch Surg. 2015;400(1):57–65. https://doi.org/10.1007/s00423-014-1255-x (PubMed PMID: 25359559).
doi: 10.1007/s00423-014-1255-x
pubmed: 25359559
Sulpice L, Rayar M, Paquet C, Bergeat D, Merdrignac A, Cunin D, et al. Does an aberrant right hepatic artery really influence the short- and long-term results of a pancreaticoduodenectomy for malignant disease? A matched case-controlled study. J Surg Res. 2013;185(2):620–5. https://doi.org/10.1016/j.jss.2013.07.015 (PubMed PMID: 24011920).
doi: 10.1016/j.jss.2013.07.015
pubmed: 24011920
Dindo D, Demartines N, Clavien P-A. Classification of surgical complications. Ann Surg. 2004;240(2):205–13. https://doi.org/10.1097/01.sla.0000133083.54934.ae .
doi: 10.1097/01.sla.0000133083.54934.ae
pubmed: 1360123
pmcid: 1360123
Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138(1):8–13. https://doi.org/10.1016/j.surg.2005.05.001 (PubMed PMID: 16003309).
doi: 10.1016/j.surg.2005.05.001
pubmed: 16003309
Grutzmann R, Ruckert F, Hippe-Davies N, Distler M, Saeger HD. Evaluation of the International Study Group of Pancreatic Surgery definition of post-pancreatectomy hemorrhage in a high-volume center. Surgery. 2012;151(4):612–20. https://doi.org/10.1016/j.surg.2011.09.039 (PubMed PMID: 22088819).
doi: 10.1016/j.surg.2011.09.039
pubmed: 22088819
Traverso LW, Freeny PC. Pancreaticoduodenectomy. The importance of preserving hepatic blood flow to prevent biliary fistula. Am Surg. 1989;55(7):421–6 (PubMed PMID: 2742226).
pubmed: 2742226
Fernandez JA, Robles R, Marin C, Sanchez-Bueno F, Ramirez P, Parrilla P. Laparoscopic iatrogeny of the hepatic hilum as an indication for liver transplantation. Liver Transpl. 2004;10(1):147–52. https://doi.org/10.1002/lt.20021 (PubMed PMID: 14755793).
doi: 10.1002/lt.20021
pubmed: 14755793
Hasegawa K, Imamura H, Akahane M, Miura Y, Takayama T, Ohtomo K, et al. Endovascular stenting for celiac axis stenosis before pancreaticoduodenectomy. Surgery. 2003;133(4):440–2. https://doi.org/10.1067/msy.2003.103 (PubMed PMID: 12717363).
doi: 10.1067/msy.2003.103
pubmed: 12717363