Anatomia arterial hepática: estudo em 150 transplantes hepáticos

Freitas, Alexandre Coutinho Teixeira de; Coelho, Júlio Cézar Uili; Matias, Jorge Eduardo Fouto; Neto, Clementino Zeni; Martins, Eduardo Lopes; Druszcz, Crhistiano Coleto

doi:10.1590/s0100-69912001000100004

Cited by 9 publications

(21 citation statements)

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“…Studies of hepatic arterial anatomy using case series of liver transplants show great diversity in the grafts, warning need for caution in surgical dissections, aiming effective arterialization and, consequently, success of the procedure in the receptor 1 , 3 , 9 , 11 , 13 .…”

Section: Discussionmentioning

confidence: 99%

Anatomic Variations of Hepatic Artery: A Study in 479 Liver Transplantations

Fonseca-Neto

Lima

Rabêlo

et al. 2017

ABCD, arq. bras. cir. dig.

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Background:The incidence of anatomic variations of hepatic artery ranges from 20-50% in different series. Variations are especially important in the context of liver orthotopic transplantation, since, besides being an ideal opportunity for surgical anatomical study, their precise identification is crucial to the success of the procedure. Aim:To identify the anatomical variations in the hepatic arterial system in hepatic transplantation. Methods: 479 medical records of transplanted adult patients in the 13-year period were retrospectively analyzed, and collected data on hepatic arterial anatomy of the deceased donor. Results:It was identified normal hepatic arterial anatomy in 416 donors (86.84%). The other 63 patients (13.15%) showed some variation. According to the Michels classification, the most frequently observed abnormalities were: right hepatic artery branch of superior mesenteric artery (Type III, n=27, 5.63%); left hepatic artery branch of the left gastric artery (Type II, n=13, 2.71%); right hepatic artery arising from the superior mesenteric artery associated with the left hepatic artery arising from the left gastric artery (Type IV, n=4, 0.83%). Similarly, in relation to Hiatt classification, the most prevalent changes were: right hepatic accessory artery or substitute of the superior mesenteric artery (Type III, n=28, 6.05%)), followed by liver ancillary left artery or replacement of gastric artery left (Type II, n=16, 3.34. Fourteen donors (2.92%) showed no anatomical abnormalities defined in classifications, the highest frequency being hepatomesenteric trunk identified in five (01.04%). Conclusion:Detailed knowledge of the variations of hepatic arterial anatomy is of utmost importance to surgeons who perform approaches in this area, particularly in liver transplantation, since their identification and proper management are critical to the success of the procedure.

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Section: Discussionmentioning

confidence: 99%

Anatomic Variations of Hepatic Artery: A Study in 479 Liver Transplantations

Fonseca-Neto

Lima

Rabêlo

et al. 2017

ABCD, arq. bras. cir. dig.

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“…The HAS variation was smaller than that reported by Ugurel et al ( 6 ) ( n = 100 cases; variation: 48%), Sebben et al ( 7 ) ( n = 40 cases; variation: 40%), and the Sobotta Anatomy Atlas ( 8 ) that records variations in 35% of the individuals. The studies developed by Pérez-Saborido et al ( 15 ) ( n = 325), Gümüs et al ( 16 ) ( n = 820), Chambers et al ( 17 ) ( n = 50), Koops et al ( 18 ) ( n = 604), and mainly the Brazilian studies developed by Freitas et al ( 19 ) ( n = 246) and Bertevello et al ( 20 ) ( n = 60) present results similar to the ones found in our investigation, with HAS variation in 27.9% of cases ( Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography

et al. 2015

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ObjectiveTo analyze the prevalence of anatomical variations of celiac arterial trunk (CAT) branches and hepatic arterial system (HAS), as well as the CAT diameter, length and distance to the superior mesenteric artery.Materials and MethodsRetrospective, cross-sectional and predominantly descriptive study based on the analysis of multidetector computed tomography images of 60 patients.ResultsThe celiac trunk anatomy was normal in 90% of cases. Hepatosplenic trunk was found in 8.3% of patients, and hepatogastric trunk in 1.7%. Variation of the HAS was observed in 21.7% of cases, including anomalous location of the right hepatic artery in 8.3% of cases, and of the left hepatic artery, in 5%. Also, cases of joint relocation of right and left hepatic arteries, and trifurcation of the proper hepatic artery were observed, respectively, in 3 (5%) and 2 (3.3%) patients. Mean length and caliber of the CAT were 2.3 cm and 0.8 cm, respectively. Mean distance between CAT and superior mesenteric artery was 1.2 cm (standard deviation = 4.08). A significant correlation was observed between CAT diameter and length, and CAT diameter and distance to superior mesenteric artery.ConclusionThe pattern of CAT variations and diameter corroborate the majority of the literature data. However, this does not happen in relation to the HAS.

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“…Hiatt et al found that variation in only 1.5% 11 . In another study with 150 liver transplants from the Liver Transplant Service of the Clinics Hospital of the Federal University of Paraná, Freitas et al demonstrated that the common hepatic artery originated from the superior mesenteric artery in 4 patients, totaling 1.62% 15 .…”

Section: Discussion Discussion Discussion Discussionmentioning

confidence: 99%

“…Therapeutic ligations are held for hepatic neoplasms, trauma and liver arterial lesions 17 . Such procedures are proscribed in liver transplant patients, as all routes of collateral circulation are interrupted during the graft collection, thus not having the mechanism to compensate for an injury to the main arterial trunk, which would cause tissue necrosis with serious consequences 15 .…”

Section: Discussion Discussion Discussion Discussionmentioning

confidence: 99%