Eleven Cases of Postoperative Hepatic Infarction Following Pancreato-Biliary Surgery

Miura, Fumihiko; Asano, Tomohiko; Amano, Hodaka; Yoshida, Masahiro; Toyota, Naoyuki; Wada, Keita; Kato, Kenichoro; Hayano, Koichi; Kadowaki, Susumu; Shibuya, Makoto; Maeno, Sawako; Takada, Tadahiro

doi:10.1007/s11605-009-1089-y

Cited by 29 publications

(17 citation statements)

References 22 publications

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“…Early in 1989, Brown et al [ 40 ] reported a case of a patient who underwent LGA embolization and suffered complications of hepatic ischaemic necrosis owing to a replaced left hepatic artery arising from it. Miura et al [ 41 ] also documented 11 patients in 2010 who had postoperative hepatic infarction after undergoing pancreato-biliary surgery and analyzed the underlying causes. In 2 of the 11 patients, the cause of hepatic infarction was inadvertent ligation of the RHA during surgery, and one patient 1 a variant RRHA originating from the SMA.…”

Section: Discussionmentioning

confidence: 99%

Rare anatomic variation of the right hepatic artery and accessory right hepatic artery supplying hepatocellular carcinoma

Liang

Li²,

Min³

et al. 2017

Medicine

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Introduction:Each hepatic artery is functionally essential for providing blood supply to the liver, and so are variant arteries. Variant arteries, including the accessory right hepatic artery (ARHA) and replaced right hepatic artery (RRHA) are commonly described in the literature. However, they usually occur independently. Here, we report an extremely rare case that involved both an ARHA and an RRHA arising from the gastroduodenal artery (GDA) and superior mesenteric artery (SMA), respectively. To date, this situation has never been reported in the literature.They were preoperatively identified during magnetic resonance imaging (MRI) examination in a 69-year-old male patient with hepatocellular carcinoma. And they were further verified by following conventional angiography for transcatheter arterial chemoembolization (TACE) for the patient. In addition, the patient's tumor was primarily supplied by these 2 variant arteries. After the successful TACE procedure, the patient had a well postoperative recovery.Conclusions:By analyzing this case and performing a systematic review of the literature, the important clinical implications of the ARHA and RRHA will be investigated and discussed. Main lessons learned from this case thorough understanding of the normal anatomy of the hepatic artery and its anatomic variation is crucial for surgeons and interventional radiologists; preoperative computed tomography, MRI, and intraoperative angiography play an important role in detecting the variant hepatic artery; identifying these anomalous hepatic arteries before operation can effectively avoid unintentional injury during surgery, such as massive hemorrhage or hepatic infarction.

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Section: Discussionmentioning

confidence: 99%

Rare anatomic variation of the right hepatic artery and accessory right hepatic artery supplying hepatocellular carcinoma

Liang

Li²,

Min³

et al. 2017

Medicine

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“…[11] Additionally, failure to preserve the arterial blood supply to the liver is particularly serious in patients undergoing PD because biliary ischemia may lead to biliary leakage or an anastomotic ischemic stricture. [12] As we have described in the current cases, there are 2 possible strategies for managing aberrant HAs; namely, preserving the trunk of the aberrant artery or removing it and performing arterial reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Aberrant hepatic arteries running through pancreatic parenchyma encountered during pancreatoduodenectomy

Wang

Xu²,

Sun³

et al. 2016

Medicine

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“…When these infarctions do occur, they are usually caused by surgical, traumatic, or septic etiologies. [1][2][3] They have also been described in the medical literature as being secondary to vasculitis -specifically polyarteritis nodosa -via hepatic vessel inflammation and occlusion. [1,4] Haratake et al described a case of hepatic infarction diagnosed during the autopsy of a 44-year-old man suffering from polyarteritis nodosa.…”

Section: Discussionmentioning

confidence: 99%

Liver infarction: To treat or not to treat?

Klein

Ackerman

et al. 2018

CRIM

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Liver infarctions are a very rare occurrence due to the multiple-source blood supply of the liver. The cause of hepatic infarction is unclear. When diagnosed, appropriate treatment of these infarctions is unknown. Herein we describe a case of acute liver infarctions, with no obvious cause, in a young woman. Work-up did not shed light on the underlying etiology. Treatment with anticoagulation was commenced in this case, with rapid improvement and a good clinical outcome. We suggest that anticoagulation can be administered to treat hepatic infarctions even in the absence of clear-cut thrombosis.

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Eleven Cases of Postoperative Hepatic Infarction Following Pancreato-Biliary Surgery

Abstract: Attention should be paid to inadvertent injury of hepatic artery to prevent hepatic infarction. Hepatic infarctions after pancreato-biliary surgery seldom extend to the entire liver and most of them are able to be treated without intervention.

Cited by 29 publications

References 22 publications

Rare anatomic variation of the right hepatic artery and accessory right hepatic artery supplying hepatocellular carcinoma

Rare anatomic variation of the right hepatic artery and accessory right hepatic artery supplying hepatocellular carcinoma

Aberrant hepatic arteries running through pancreatic parenchyma encountered during pancreatoduodenectomy

Liver infarction: To treat or not to treat?

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