BALZAN, Silvio Marcio Pegoraro GAVA, Vinicius Grando PEDROTTI, Sabrina MAGALHÃES, Marcelo Arbo SCHWENGBER, Alex DOTTO, Marcelo Luiz KREBS, Carmela Reckziegel PREVALENCE OF HEPATIC ARTERIAL VARIATIONS WITH IMPLICATIONS IN PANCREATODUODENECTOMY <div><p>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.</p></div> Pancreaticoduodenectomy;Hepatic artery;Pancreatic neoplasms 2019-10-23
    https://scielo.figshare.com/articles/dataset/PREVALENCE_OF_HEPATIC_ARTERIAL_VARIATIONS_WITH_IMPLICATIONS_IN_PANCREATODUODENECTOMY/10025690
10.6084/m9.figshare.10025690.v1