The meta-analysis and systematic review of prevalence and clinical anatomy of the arc of Buhler

Abstract

The arc of Buhler (AOB) is a direct anastomosis of the celiac axis and superior mesenteric artery. This paper reviews the literature on the AOB and provides accurate and up-to-date data on its prevalence, anatomy, and clinical significance. The main scholarly online databases were carefully searched for relevant studies related to the AOB. Information was gathered and formed the basis of the analysis of this study. In total, 11 studies were used in this meta-study, consisting of 3685 total patients tested and 50 cases of the AOB presented. The pooled prevalence estimate of the AOB was determined to be 1.7% (95% CI 0.9, 2.9). By imaging type, the prevalence of the AOB was 1.8% for radiological studies (n = 3485; 95% CI 0.9, 3.0), 1.4% for computed tomography (CT) studies (n = 1417; 95% CI 0.4, 3.0), and 1.9% for angiography studies (n = 2068; 95% CI 0.5, 4.0). The AOB is sufficiently significant and should be considered when planning surgeries or radiological procedures involving the abdomen.

Pancreaticoduodenectomy in Patients With Coeliac or Superior Mesenteric Artery Stenosis: A Review of the Literature

“…Arc of Buhler (AoB) is a rare anatomical variant which is a direct arterial communication between the CA and the SMA and is present in 1-3% of patients, and when preserved it can provide alternative blood flow to the hepatic artery in cases of CAS [ 64 ]. In this review, two patients had successful preservation of AOB and of blood supply to HA.…”

A Unique Arc of Bühler Variant Connecting the Arteries of the Foregut, Midgut, and Hindgut and Its Surgical Significance

“…This persistent anastomosis forms the AOB [ 3 ]. Based on a recent systematic review, the AOB is considered an uncommon vascular anomaly with a prevalence that ranges between 1% and 4% with an average of 1.7% [ 4 ].…”