Destruction of a wandering accessory right hepatic artery in a patient with pancreatic body cancer: a case report

Kikuya, Kenta; Einama, Takahiro; Miyata, Yuhei; Iwasaki, Tetsushi; Yamagishi, Yoji; Takihata, Yasuhiro; Morimura, Fumio; Edo, Hiromi; Otsuka, Yasuhiro; Mori, Shiro; Tsunenari, Takazumi; Fujinuma, Ibuki; Hirose, Yoshio; Tsujimoto, Hironori; Ueno, Hideki; Kishi, Yoji

doi:10.1007/s12328-020-01304-3

Cited by 3 publications

(2 citation statements)

References 29 publications

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“…In some reports, replaced hepatic artery was sometimes sacrificed without reconstruction which could not lead to serious adverse events or compromised oncological outcomes [ 18 ]. Other articles described that resection the replaced hepatic artery could lead to severe morbidities such as liver necrosis and liver failure, which advised that the replaced hepatic artery should be reconstructed [ 19 ]. In a study observed ligation of aberrant LHA in 204 patients, Ang et al [ 20 ] concluded that ligation of replaced LHA is safe as it only resulted in transient rise of liver enzymes.…”

Section: Discussionmentioning

confidence: 99%

A rare case with multiple arterial variations of the liver complicated laparoscopic pancreaticoduodenectomy

et al. 2022

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Background Hepatic arterial variations were fully elaborated in anatomical monographs. Here, we aimed to present a rare case with multiple arterial variations of the liver complicated laparoscopic pancreaticoduodenectomy. Case presentation We report a 67-year-old woman with a periampullary tumor underwent laparoscopic pancreaticoduodenectomy. Intraoperatively, the aberrant right hepatic artery derived from the gastroduodenal artery (GDA) was observed and had accidentally sacrificed due to untimely ligature of GDA. Three-dimensional reconstruction based on preoperative contrast-enhanced CT performed to better study the anatomy. It demonstrated a replaced right hepatic artery branched from the GDA and supplied right liver lobe. Meanwhile, the middle hepatic artery derived from the common hepatic artery and supplied hepatic segment IV. Additionally, the replaced left hepatic artery emerged from the left gastric artery and fed into left liver lobe. Conclusions The origination and course of hepatic arterial anatomy should be thoroughly assessed in planning and performing hepatopancreatobiliary surgeries. Reconstruction images of contrast-enhanced CT are helpful to visualize the vascular variations and its spatial relation with adjacent structures.

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Section: Discussionmentioning

confidence: 99%

A rare case with multiple arterial variations of the liver complicated laparoscopic pancreaticoduodenectomy

et al. 2022

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“…The middle hepatic artery comes from the junction of the common hepatic and gastroduodenal artery also called the proper hepatic artery representing the middle branch. Normally during the course of the development, the left and right hepatic arteries disappear, and only the middle hepatic artery persists as the main blood supply of the liver [ 16 ]. Non-disappearance of the left and right hepatic arteries or persistence of their interconnection may give rise to aberrant or various types of arterial variations [ 17 ].…”

Section: Embryologymentioning

confidence: 99%

Importance of Anatomical Variation of the Hepatic Artery for Complicated Liver and Pancreatic Surgeries: A Review Emphasizing Origin and Branching

Malviya

Verma

2023

Diagnostics

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Knowledge of anatomical variations of the hepatic artery from its origin to intrahepatic segmentation is of utmost importance for planning upper abdominal surgeries including liver transplantation, pancreatoduodenectomy, and biliary reconstruction. The origin and branching pattern of the hepatic artery was thoroughly described by the classification of Michels and Hiatt. Some rare variations of the hepatic artery were classified by Kobayashi and Koops. By the use of the multidetector computed tomography (MDCT) technique, the branching pattern of the hepatic artery can be visualized quite accurately. Unawareness of these arterial variations may lead to intraoperative injuries such as necrosis, abscess, and failure of the liver and pancreas. The origin and course of the aberrant hepatic arteries are crucial in the surgical planning of carcinoma of the head of the pancreas and hepatobiliary surgeries. In liver transplant surgeries, to minimize intraoperative bleeding complications and postoperative thrombosis, exact anatomy of the branching of the hepatic artery, its variations and intrahepatic course is of utmost importance. This review discusses variations in the anatomy of the hepatic artery from its origin to branching by the use of advanced imaging techniques and its effect on the liver, pancreatic, biliary and gastric surgeries.

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Clinical significance of variant hepatic artery in pancreatic resection: A comprehensive review

Xu¹,

Yang²,

Fu³

2022

WJG

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Destruction of a wandering accessory right hepatic artery in a patient with pancreatic body cancer: a case report

Cited by 3 publications

References 29 publications

A rare case with multiple arterial variations of the liver complicated laparoscopic pancreaticoduodenectomy

A rare case with multiple arterial variations of the liver complicated laparoscopic pancreaticoduodenectomy

Importance of Anatomical Variation of the Hepatic Artery for Complicated Liver and Pancreatic Surgeries: A Review Emphasizing Origin and Branching

Clinical significance of variant hepatic artery in pancreatic resection: A comprehensive review

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