Trofin AM, Vlad N, Zabara M, Rusu-Andriesi D, Bradea C, Vornicu A, Cadar R, Târcoveanu E, Lupascu-Ursulescu C, Lupascu CD. Pancreaticoduodenectomy In Patients With Hepatic Artery, Anatomic Variants: Tailoring, Perioperative Care and Surgical Outcomes.
Rev Med Chir Soc Med Nat Iasi 2016;
120:874-879. [PMID:
30141846]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION
Pancreaticoduodenectomy (PD) is the procedure of choice in patients with tumors of pancreatic head or periampullary region. Hepatic artery anatomic variants (HAav) are frequently encountered during PD.
AIM
To evaluate the incidence of HAav in a series of PDs and their consequence on technical tailoring and outcome.
MATERIAL AND METHODS
Forty-five patients with HAav were identified in a consecutive series of 140 PDs for periampullary and pancreatic head tumors performed between January 1, 2007 and December 31, 2015. The groups with or without HAav were compared in terms of operative approach, complications and survival.
RESULTS
All patients underwent Whipple procedure, with right posterior approach for those having HAav. HAav was spared without damage in 41 cases. Four patients in whom the HAav were either sacrificed (2) or damaged (2) required arterial reconstruction.
CONCLUSIONS
HAav are frequently encountered during PD. Its safeguarding is mandatory but in malignancy it can be damaged or sacrificed, hence arterial reconstruction is required. HAav have no negative impact on surgical morbidity and outcome.
Collapse