Implicaciones de las variantes arteriales hepáticas durante la duodenopancreatectomía cefálica oncológica
2015
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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