Pancreatoduodenectomy for cancer is a complex surgical procedure with significant morbidity and mortality. Technical aspects of this procedure typically comprise dissection of celiac trunk, the common and the proper hepatic arteries. The presence of hepatic arterial anomalies is not uncommon and influences surgical technique. An aberrant right hepatic artery (replaced or accessory) or a common hepatic artery originating from the superior mesenteric artery are present in nearly 13% of cases and usually run in contact with the posterior aspect of the head of the pancreas. These anomalous arteries are at risk of iatrogenic injury and tumor involvement. Iatrogenic vascular lesions can lead to bleeding and/or ischemic complications, such as anastomotic stenosis, hepatic abscess and liver failure. Also, vascular tumor involvement might require arterial resection and reconstruction. The presence of arterial variations should not affect the radicalness of pancreatic resection as the involvement of aberrant arteries does not seem to affect postoperative outcomes or overall survival. These vascular variations should be, preferably, recognized pre-operatively in order to define possible surgical strategies. Preoperative contrast enhanced computed tomography provides accurate arterial anatomy evaluation. Lastly, aberrant hepatic arteries require proper dissection and/or occasionally resection and reconstruction during pancreatoduodenectomy to achieve a safe resection with proper radicalness. Knowledge of arterial variations is crucial for pancreatic cancer surgery.
| Published in | Journal of Surgery (Volume 8, Issue 1) |
| DOI | 10.11648/j.js.20200801.12 |
| Page(s) | 5-8 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2020. Published by Science Publishing Group |
Pancreatic Cancer, Pancreatoduodenectomy, Arterial Variations, Pancreatic Surgery
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APA Style
Silvio Marcio Pegoraro Balzan, Vinicius Grando Gava, Érika Luiza Maschio, Victoria Lucateli Bernardi, Giana da Silva Lima, et al. (2020). Implications of Arterial Variations in Pancreatoduodenectomy for Cancer. Journal of Surgery, 8(1), 5-8. https://doi.org/10.11648/j.js.20200801.12
ACS Style
Silvio Marcio Pegoraro Balzan; Vinicius Grando Gava; Érika Luiza Maschio; Victoria Lucateli Bernardi; Giana da Silva Lima, et al. Implications of Arterial Variations in Pancreatoduodenectomy for Cancer. J. Surg. 2020, 8(1), 5-8. doi: 10.11648/j.js.20200801.12
AMA Style
Silvio Marcio Pegoraro Balzan, Vinicius Grando Gava, Érika Luiza Maschio, Victoria Lucateli Bernardi, Giana da Silva Lima, et al. Implications of Arterial Variations in Pancreatoduodenectomy for Cancer. J Surg. 2020;8(1):5-8. doi: 10.11648/j.js.20200801.12
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Download@article{10.11648/j.js.20200801.12,
author = {Silvio Marcio Pegoraro Balzan and Vinicius Grando Gava and Érika Luiza Maschio and Victoria Lucateli Bernardi and Giana da Silva Lima and Graziela de Gasperi and Morgana Pizzolatti Marins and Vanessa Batistella Kunzler and Bruna Aparecida Fontana Costa},
title = {Implications of Arterial Variations in Pancreatoduodenectomy for Cancer},
journal = {Journal of Surgery},
volume = {8},
number = {1},
pages = {5-8},
doi = {10.11648/j.js.20200801.12},
url = {https://doi.org/10.11648/j.js.20200801.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200801.12},
abstract = {Pancreatoduodenectomy for cancer is a complex surgical procedure with significant morbidity and mortality. Technical aspects of this procedure typically comprise dissection of celiac trunk, the common and the proper hepatic arteries. The presence of hepatic arterial anomalies is not uncommon and influences surgical technique. An aberrant right hepatic artery (replaced or accessory) or a common hepatic artery originating from the superior mesenteric artery are present in nearly 13% of cases and usually run in contact with the posterior aspect of the head of the pancreas. These anomalous arteries are at risk of iatrogenic injury and tumor involvement. Iatrogenic vascular lesions can lead to bleeding and/or ischemic complications, such as anastomotic stenosis, hepatic abscess and liver failure. Also, vascular tumor involvement might require arterial resection and reconstruction. The presence of arterial variations should not affect the radicalness of pancreatic resection as the involvement of aberrant arteries does not seem to affect postoperative outcomes or overall survival. These vascular variations should be, preferably, recognized pre-operatively in order to define possible surgical strategies. Preoperative contrast enhanced computed tomography provides accurate arterial anatomy evaluation. Lastly, aberrant hepatic arteries require proper dissection and/or occasionally resection and reconstruction during pancreatoduodenectomy to achieve a safe resection with proper radicalness. Knowledge of arterial variations is crucial for pancreatic cancer surgery.},
year = {2020}
}
TY - JOUR T1 - Implications of Arterial Variations in Pancreatoduodenectomy for Cancer AU - Silvio Marcio Pegoraro Balzan AU - Vinicius Grando Gava AU - Érika Luiza Maschio AU - Victoria Lucateli Bernardi AU - Giana da Silva Lima AU - Graziela de Gasperi AU - Morgana Pizzolatti Marins AU - Vanessa Batistella Kunzler AU - Bruna Aparecida Fontana Costa Y1 - 2020/01/17 PY - 2020 N1 - https://doi.org/10.11648/j.js.20200801.12 DO - 10.11648/j.js.20200801.12 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 5 EP - 8 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20200801.12 AB - Pancreatoduodenectomy for cancer is a complex surgical procedure with significant morbidity and mortality. Technical aspects of this procedure typically comprise dissection of celiac trunk, the common and the proper hepatic arteries. The presence of hepatic arterial anomalies is not uncommon and influences surgical technique. An aberrant right hepatic artery (replaced or accessory) or a common hepatic artery originating from the superior mesenteric artery are present in nearly 13% of cases and usually run in contact with the posterior aspect of the head of the pancreas. These anomalous arteries are at risk of iatrogenic injury and tumor involvement. Iatrogenic vascular lesions can lead to bleeding and/or ischemic complications, such as anastomotic stenosis, hepatic abscess and liver failure. Also, vascular tumor involvement might require arterial resection and reconstruction. The presence of arterial variations should not affect the radicalness of pancreatic resection as the involvement of aberrant arteries does not seem to affect postoperative outcomes or overall survival. These vascular variations should be, preferably, recognized pre-operatively in order to define possible surgical strategies. Preoperative contrast enhanced computed tomography provides accurate arterial anatomy evaluation. Lastly, aberrant hepatic arteries require proper dissection and/or occasionally resection and reconstruction during pancreatoduodenectomy to achieve a safe resection with proper radicalness. Knowledge of arterial variations is crucial for pancreatic cancer surgery. VL - 8 IS - 1 ER -
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