Right hepatic artery anomalies in pancreatoduodenectomy-a risk for arterial resection but not for postoperative outcomes.

Autor:	La Vaccara V; Department of General Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy., Coppola A; Department of Surgery, Sapienza University of Rome, Rome, Italy., Cammarata R; Department of General Surgery, Università Campus Bio-Medico di Roma, Rome, Italy., Olivieri L; Department of General Surgery, Università Campus Bio-Medico di Roma, Rome, Italy., Farolfi T; Department of General Surgery, Università Campus Bio-Medico di Roma, Rome, Italy., Coppola R; Department of General Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.; Department of General Surgery, Università Campus Bio-Medico di Roma, Rome, Italy., Caputo D; Department of General Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.; Department of General Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Journal of gastrointestinal oncology [J Gastrointest Oncol] 2023 Oct 31; Vol. 14 (5), pp. 2158-2166. Date of Electronic Publication: 2023 Oct 27.
DOI:	10.21037/jgo-23-191
Abstrakt:	Background: Pancreatoduodenectomy (PD) is a complex surgical procedure known for its significant morbidity rates, and the presence of an aberrant hepatic artery (AHA) introduces additional challenges. The impact of AHA on post-PD outcomes has been a subject of conflicting findings in the medical literature. This study aimed to investigate how variations in hepatic arterial anatomy influence intra-operative variables and postoperative morbidity. Methods: A retrospective analysis was conducted on 113 PD cases. Patients with variant hepatic arterial anatomy (n=38) were categorized as Group 1, while those without vascular abnormalities comprised Group 2. Perioperative and postoperative outcomes were examined. Results: Patients in Groups 1 and 2 exhibited similar characteristics, and no notable differences in surgical complications were observed. There was, however, a noticeable trend towards a higher incidence of postpancreatectomy hemorrhage (PPH) in Group 1 (31.6% vs. 20.0%; P=0.17). Furthermore, a statistically significant increase in the rate of arterial resections was noted in patients with vascular anomalies (10.5% vs. 1.33%; P=0.02). Conclusions: The prevalence of vascular abnormalities in the hepatic arterial circulation is more frequent than initially anticipated. These anomalies present additional complexities to the already intricate PD procedure, leading to a heightened necessity for arterial resection, albeit without any discernible impact on postoperative complications. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jgo.amegroups.com/article/view/10.21037/jgo-23-191/coif). The authors have no conflicts of interest to declare. (2023 Journal of Gastrointestinal Oncology. All rights reserved.)
Databáze:	MEDLINE
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