| Autor: |
Silvio Marcio Pegoraro BALZAN, Vinicius Grando GAVA, Sabrina PEDROTTI, Marcelo Arbo MAGALHÃES, Alex SCHWENGBER, Marcelo Luiz DOTTO, Carmela Reckziegel KREBS |
| Jazyk: |
English<br />Portuguese |
| Předmět: |
|
| Zdroj: |
ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| Druh dokumentu: |
article |
| ISSN: |
0102-6720 |
| DOI: |
10.1590/0102-672020190001e1455 |
| Popis: |
ABSTRACT Background: Pancreaticoduodenectomy is the usual surgical option for curative treatment of periampullary cancer and carries a significant mortality. Arterial anomalies of the celiac axis are not uncommon and might lead to iatrogenic lesions or requiring arterial resection/reconstruction in a pancreatoduodenectomy. Aim: Determine the prevalence of arterial variations having implications in pancreatoduodenectomy. Methods: Celiac trunk and hepatic arterial system anatomy was retrospectively evaluated in 200 abdominal enhanced computed tomography studies. Results: Normal anatomy of hepatic arterial system was found in 87% of cases. An anomalous right hepatic artery was identified in 13% of cases. In 12 cases there was a substitute right hepatic artery arising from superior mesenteric artery and in two cases an accessory right hepatic artery with similar origin. A hepatomesenteric trunk was identified in seven cases and in five there was a right hepatic artery directly from the celiac trunk. All cases of anomalous right hepatic artery had a route was behind the pancreatic head and then, posteriorly and laterally, to the main portal vein before reaching the liver. Conclusions: Hepatic artery variations, such as anomalous right hepatic artery crossing posterior to the portal vein, are frequently seen (13%). These patients, when undergoing pancreatoduodenectomy, may require a change in the surgical approach to achieve an adequate resection. Preoperative imaging can clearly identify such variations and help to achieve a safer pancreatic head dissection with proper surgical planning. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
|
