Year 2015 / Volume 107 / Number 7
Original
Implication of the presence of a variant hepatic artery during the Whipple procedure

417-422

Mercedes Rubio-Manzanares-Dorado, Luis Miguel Marín-Gómez, Daniel Aparicio-Sánchez, Gonzalo Suárez-Artacho, Carmen Bellido, José María Álamo, Juan Serrano-Díaz-Canedo, Francisco Javier Padillo-Ruiz and Miguel Ángel Gómez-Bravo

Abstract
Introduction: The anatomical variants of the hepatic artery may have important implications for pancreatic cancer surgery. The aim of our study is to compare the outcome following a pancreatoduodenectomy (PD) in patients with or without a variant hepatic artery arising from superior mesenteric artery.
Material and methods: We reviewed 151 patients with periampullary tumoral pathology. All patients underwent oncological PD between January 2005 and February 2012. Our series was divided into two groups: Group A: Patients with a hepatic artery arising from superior mesenteric artery; and Group B: Patients without a hepatic artery arising from superior mesenteric artery. We expressed the results as mean ± standard deviation for continuous variables and percentages for qualitative variables. Statistical tests were considered significant if p < 0.05.
Results: We identified 11 patients with a hepatic artery arising from superior mesenteric artery (7.3%). The most frequent variant was an aberrant right hepatic artery (n = 7), following by the accessory right hepatic artery (n = 2) and the common hepatic artery trunk arising from the superior mesenteric artery (n = 2). In 73% of cases the diagnosis of the variant was intraoperative. R0 resection was performed in all patients with a hepatic artery arising from superior mesenteric artery. There were no significant differences in the tumor resection margins and the incidence of postoperative complications.
Conclusion: Oncological PD is feasible by the presence of a hepatic artery arising from superior mesenteric artery. The complexity of having it does not seem to influence in tumor resection margins, complications and survival.
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Mercedes Rubio-Manzanares-Dorado, Luis Miguel Marín-Gómez, Daniel Aparicio-Sánchez, Gonzalo Suárez-Artacho, Carmen Bellido, José María Álamo, Juan Serrano-Díaz-Canedo, Francisco Javier Padillo-Ruiz and Miguel Ángel Gómez-Bravo. Implication of the presence of a variant hepatic artery during the Whipple procedure. 417-422


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