Clinical relevance of hepatic artery variation during duodenopancreatectomy
10.3760/cma.j.issn.1674-1935.2009.04.003
- VernacularTitle:胰十二指肠切除术中肝动脉变异及意义
- Author:
Jian WANG
;
Min XIE
;
Shanhua BAO
- Publication Type:Journal Article
- Keywords:
Pancreaticoduodenectomy;
Hepatic artery;
Variation (genetics)
- From:
Chinese Journal of Pancreatology
2009;9(4):226-228
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical relevance of hepatic artery variation during the procedure of duodenopancreatectomy. Methods Data of 100 patients who underwent duodenopancreatectomy were retrospectively reviewed, and the anatomy of hepatic artery variation was evaluated, then the types of variation and specific intra-operative managements were recorded. Results Through pre-operative celiac artery and superior mesenteric artery DSA and duodenohepatic ligament skeletonization during operation, 16 cases were found to have hepatic artery variation, and 14 (14%) patients had alternative hepatic artery, among them there were 10 cases of alternative right hepatic artery (10%) , 8 cases originated from superior mesenteric artery, 2 cases originated from gastroduodenal artery. 4(4%) patients had alternative left hepatic artery, 3 of them originated from left gastric artery, 1 originated from right hepatic artery. The diameter of variant artery was 0.3 -0.6 cm with a mean of 0. 47 cm. All the variant arteries were reserved in operation. 1 patient had a variant hepatic artery located in the posterior of hepatoduodenal ligament parallel with portal vein, and the diameter of this variant artery was 0. 4 cm, the variant artery was reserved. 1 patient had a variant hepatic artery towards right hepatic lobe which originated from the direction of pancreatic head, and the diameter of this variant artery was 0.2 cm, the artery was dissected 1 h after artery occlusion. Conclusions Whether variant blood vessel need to be reserved shall be judged according to blood vessel diameter, the changes of liver in the course of variant artery occlusion and suggestions from blood vessel surgeon.
