Aberrant Hepatic Artery in Patients Undergoing Pancreaticoduodenectomy

Yang, Feng; Jiang, Long; Fu, De Liang; Jin, Chen; Lei, Yu; Xu, Jin; Ni, Quan Xing

doi:10.1159/000114867

Cited by 31 publications

(20 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most likely aberrant HA expected during planning or performing PD is replaced or accessory RHA [1,2,8]. In our present study, RHA variations were found in 15 patients (14.6%) who underwent PD, and replaced RHA from SMA also was the most common aberrant HA with frequency of 11.6% (Table 1).…”

Section: Discussionsupporting

confidence: 53%

“…The frequencies of normal HA pattern are reported as 53.5-79.1%, whereas replaced or accessory LHA arising from the LGA is reported as 3-14.2% and replaced or accessory RHA branching off the SMA is reported as 8.7-18% [1,2,4,7]. Therefore, surgeons should be familiar with these variants so that they can avoid various surgical complications [8]. Although Suzuki and Nakayasu [9] classified hepatic arterial variations, Michel's classification is more useful because it established the differences between ''an accessory'' and ''a replaced'' artery [3,7].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Implications of an Aberrant Right Hepatic Artery in Patients Undergoing Pancreaticoduodenectomy

Lee

Kim

et al. 2009

World j. surg.

View full text Add to dashboard Cite

Background Sometimes, it seems to be difficult to preserve the aberrant hepatic artery (HA) during pancreaticoduodenectomy (PD), with respect to en bloc lymph node dissection, especially in the case of aberrant right hepatic artery (RHA). Therefore, we evaluated the influence of incomplete en bloc lymph node (LN) dissection when aberrant RHA arises. Methods We reviewed 103 patients with mid-to-distal common bile duct (CBD) cancers who underwent PD by one surgeon at Asan Medical Center from December 1994 to November 2005 (73 men, 30 women; mean age, 61.1 ± 9.4 (range: 40-84) years). The mean follow-up period was 32.7 months. We compared the normal RHA group with the aberrant RHA group. Results Eighty-eight cases showed normal RHA anatomy, including nine cases (8.7%) of aberrant left hepatic artery (LHA) with normal RHA cases (normal HA group). RHA anomalies were observed in 15 cases (14.6%, aberrant HA group). In all cases, there was no direct invasion of cancer to aberrant HA. Among two groups, 43 cases (41.7%) showed recurrence and there was no significant difference in recurrence between two groups (p = 0.202). Three-year and 5-year overall survivals were 33.3% and 28.5% in the normal HA group, whereas 47.1% and 28.3% in the aberrant RHA group, respectively. There also was no statistically significant difference in survival (p = 0.763). Conclusions When performing PD for CBD cancer, aberrant RHA should be preserved if there was no cancerous invasion and it does not seem to affect the recurrence of disease and overall survival of patients.

show abstract

Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Clinical Implications of an Aberrant Right Hepatic Artery in Patients Undergoing Pancreaticoduodenectomy

Lee

Kim

et al. 2009

World j. surg.

View full text Add to dashboard Cite

show abstract

“…Thus, strategies to improve the sensitivity of chemotherapy should include anti-hypoxia and anti-stroma cells, and should increase the local concentration of chemotherapy drugs. Many studies have demonstrated promising results of intra-arterial chemotherapy via the femoral artery under digital subtraction angiography with the tip inserted directly into the hepatic artery and the superior mesenteric artery for pancreatic cancer treatment 78, 79. Intra-arterial chemotherapy may lead to higher drug concentration in the pancreas compared to systemic chemotherapy, and could improve the therapeutic effect.…”

Section: Strategies To Overcome Drug Resistance In Pancreatic Cancermentioning

confidence: 99%

Overcoming drug resistance in pancreatic cancer

Jiang

Zhang

et al. 2011

Expert Opinion on Therapeutic Targets

Self Cite

211

181

View full text Add to dashboard Cite

Introduction Pancreatic cancer has the worst survival rate of all cancers. The current standard care for metastatic pancreatic cancer is gemcitabine, however, the success of this treatment is poor and overall survival has not improved for decades. Drug resistance (both intrinsic and acquired) is thought to be a major reason for the limited benefit of most pancreatic cancer therapies. Areas covered Previous studies have indicated various mechanisms of drug resistance in pancreatic cancer, including changes in individual genes or signaling pathways, the influence of the tumor microenvironment, and the presence of highly resistant stem cells. This review summarizes recent advances in the mechanisms of drug resistance in pancreatic cancer, and potential strategies to overcome this. Expert Opinion Increasing drug delivery efficiency and decreasing drug resistance is the current aim in pancreatic cancer treatment, and will also benefit the treatment of other cancers. Understanding the molecular and cellular basis of drug resistance in pancreatic cancer will lead to the development of novel therapeutic strategies with the potential to sensitize pancreatic cancer to chemotherapy, and to increase the efficacy of current treatments in a wide variety of human cancers.

show abstract

“…Normal variations are important to be demonstrated angiographically before any hepato biliary pancreatic and liver transplantation surgery, because accidental ligation of aberrant hepatic arteries may result in hepatic necrosis, ischemic biliary injury , graft injury or breakdown of biliary enteric anastomosis 6 . The present case is neither a case of accessory or replaced hepatic artery but the longer course and the altered relation with biliary system may make it vulnerable to injury during surgery.…”

Section: Discussionmentioning

confidence: 99%