Reconstrucción de la arteria hepática derecha aberrante en la duodeno-pancreatectomía cefálica

Dorado, Mercedes Rubio-Manzanares; Gómez, Luis Miguel Marín; Díez-Canedo, J. Serrano; Padillo-Ruíz, Javier; Bravo, Miguel Ángel Gómez

doi:10.1016/j.ciresp.2013.05.003

Cited by 3 publications

(3 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A careful technique performed by expert hands may be sufficient to prevent inadvertent injury. Therefore, if the variant presents an intraparenchymal course or is infiltrated by the tumor, it may be necessary to perform an arterial resection and later revascularization (10). Although no significant differences were found between the two groups, it is remarkable that 17% in group B showed positive margins versus 0% in patients with hepatic arterial variant.…”

Section: Discussionmentioning

confidence: 58%

See 1 more Smart Citation

Implication of the presence of a variant hepatic artery during the Whipple procedure

Rubio-Manzanares-Dorado¹,

Marín-Gómez²,

Aparicio-Sánchez³

et al. 2015

Rev Esp Enferm Dig

View full text Add to dashboard Cite

Introduction:The anatomical variants of the hepatic artery may have important implications for pancreatic cancer surgery. The aim of our study is to compare the outcome following a pancreatoduodenectomy (PD) in patients with or without a variant hepatic artery arising from superior mesenteric artery. Material and methods:We reviewed 151 patients with periampullary tumoral pathology. All patients underwent oncological PD between January 2005 and February 2012. Our series was divided into two groups: Group A: Patients with a hepatic artery arising from superior mesenteric artery; and Group B: Patients without a hepatic artery arising from superior mesenteric artery. We expressed the results as mean ± standard deviation for continuous variables and percentages for qualitative variables. Statistical tests were considered significant if p < 0.05. Results:We identified 11 patients with a hepatic artery arising from superior mesenteric artery (7.3%). The most frequent variant was an aberrant right hepatic artery (n = 7), following by the accessory right hepatic artery (n = 2) and the common hepatic artery trunk arising from the superior mesenteric artery (n = 2). In 73% of cases the diagnosis of the variant was intraoperative. R0 resection was performed in all patients with a hepatic artery arising from superior mesenteric artery. There were no significant differences in the tumor resection margins and the incidence of postoperative complications.Conclusion: Oncological PD is feasible by the presence of a hepatic artery arising from superior mesenteric artery. The complexity of having it does not seem to influence in tumor resection margins, complications and survival.

show abstract

Section: Discussionmentioning

confidence: 58%

“…An improper vascularization may delay the restoration of liver function. Different authors recommend arterial reconstruction in case of tumor infiltration or in cases where the intraparenchymal course not ensure an R0 resection (5,10,20,21). There are many arterial reconstructive techniques for the RHA after section.…”

Section: Discussionmentioning

confidence: 99%

Implication of the presence of a variant hepatic artery during the Whipple procedure

Rubio-Manzanares-Dorado¹,

Marín-Gómez²,

Aparicio-Sánchez³

et al. 2015

Rev Esp Enferm Dig

View full text Add to dashboard Cite

show abstract

“…The lymph node yield, the rate of tumor-free resection margin and long-term survival were also not affected by the presence of aRHA in oncologic patients. Six studies found significantly longer duration of surgery in patients with aRHA (7,8,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26).…”

Section: Systematic Review Of the Literaturementioning

confidence: 99%

Preservation of aberrant right hepatic arteries does not affect safety and oncological radicality of pancreaticoduodenectomy—own results and a systematic review of the literature

Pyras¹,

Lukas²,

Janot‐Matuschek³

et al. 2022

Hepatobiliary Surg Nutr

View full text Add to dashboard Cite

Background: Aberrant right hepatic arteries (aRHA) are frequently encountered during pancreaticoduodenectomy (PD). Their effects on surgical morbidity and resection margin are still debated.This study aimed to compare the short term and long term outcomes in patients with and without aRHA.Methods: A single-center retrospective analysis of 353 consecutive PD during a 5-year period was done. The type of arterial supply was determined preoperatively by CT and confirmed at surgery. Hiatt types III-VI included some type of aRHA and comprised the study group. Hiatt types I and II were considered irrelevant for PD and used as controls. Primary endpoints were the rates of major postoperative complications and the rate of R0-resection in cases of malignant disease. Secondary endpoints included duration of surgery, postoperative stay, number of harvested lymph nodes and survival in patients with pancreatic cancer. Own results were compared to existent data using a systematic review of the literature.Results: No aRHA had to be sacrificed or reconstructed. Surgical morbidity and specific complications such as post-pancreatectomy hemorrhage (PPH), pancreatic fistula and bile leak were the same in patients with and without aRHA. There was no significant difference in operative time, blood loss, length of ICUand hospital stay. Patients with malignancy had similar high rates of R0-resection and identical number of harvested lymph nodes. Survival of patients with pancreatic cancer was not affected by aRHA.Conclusions: aRHA may be preserved in virtually all cases of PD for resectable pancreatic head lesions without increasing surgical morbidity and without compromising oncological radicality in patients with cancer, provided the variant anatomy is being recognised on preoperative CT and a meticulous surgical technique is used.

show abstract

The absence of the common hepatic artery and its implications for surgical practice: Results of a systematic review and meta-analysis

et al. 2019

View full text Add to dashboard Cite

Reconstrucción de la arteria hepática derecha aberrante en la duodeno-pancreatectomía cefálica

Cited by 3 publications

References 6 publications

Implication of the presence of a variant hepatic artery during the Whipple procedure

Implication of the presence of a variant hepatic artery during the Whipple procedure

Preservation of aberrant right hepatic arteries does not affect safety and oncological radicality of pancreaticoduodenectomy—own results and a systematic review of the literature

The absence of the common hepatic artery and its implications for surgical practice: Results of a systematic review and meta-analysis

Contact Info

Product

Resources

About