Clinical Implications of an Aberrant Right Hepatic Artery in Patients Undergoing Pancreaticoduodenectomy

Jae-Myeong Lee; Young-Joo Lee; Kim, Chan-Wook; Moon, Ki-Miung; Kim, Myung-Wook
August 2009
World Journal of Surgery;Aug2009, Vol. 33 Issue 8, p1727
Academic Journal
Sometimes, it seems to be difficult to preserve the aberrant hepatic artery (HA) during pancreaticoduodenectomy (PD), with respect to en bloc lymph node dissection, especially in the case of aberrant right hepatic artery (RHA). Therefore, we evaluated the influence of incomplete en bloc lymph node (LN) dissection when aberrant RHA arises. We reviewed 103 patients with mid-to-distal common bile duct (CBD) cancers who underwent PD by one surgeon at Asan Medical Center from December 1994 to November 2005 (73 men, 30 women; mean age, 61.1 ± 9.4 (range: 40–84) years). The mean follow-up period was 32.7 months. We compared the normal RHA group with the aberrant RHA group. Eighty-eight cases showed normal RHA anatomy, including nine cases (8.7%) of aberrant left hepatic artery (LHA) with normal RHA cases (normal HA group). RHA anomalies were observed in 15 cases (14.6%, aberrant HA group). In all cases, there was no direct invasion of cancer to aberrant HA. Among two groups, 43 cases (41.7%) showed recurrence and there was no significant difference in recurrence between two groups ( p = 0.202). Three-year and 5-year overall survivals were 33.3% and 28.5% in the normal HA group, whereas 47.1% and 28.3% in the aberrant RHA group, respectively. There also was no statistically significant difference in survival ( p = 0.763). When performing PD for CBD cancer, aberrant RHA should be preserved if there was no cancerous invasion and it does not seem to affect the recurrence of disease and overall survival of patients.


Related Articles

  • Adequacy of Lymph Node Retrieval for Ampullary Cancer and Its Association with Improved Staging and Survival. Partelli, Stefano; Crippa, Stefano; Capelli, Paola; Neri, Anna; Bassi, Claudio; Zamboni, Giuseppe; Barugola, Giuliano; Falconi, Massimo // World Journal of Surgery;Jun2013, Vol. 37 Issue 6, p1397 

    Background: The aim of the present study was to determine the optimal number of lymph nodes (LN) examined to stage pN0 tumors after surgery for ampulla of Vater carcinoma (AVC). Methods: We reviewed retrospectively 127 patients with AVC who underwent pancreaticoduodenectomy (1990-2008)....

  • Surgical strategy of biliary papillomatosis in Western countries. Vibert, Eric; Dokmak, Safi; Belghiti, Jacques // Journal of Hepato -- Biliary -- Pancreatic Sciences;May2010, Vol. 17 Issue 3, p241 

    Surgical resection, considered the optimal treatment of biliary papillomatosis, often remains incomplete due to high risk of recurrence in view of positive margins or recurrence on the remnant bile duct because of its multifocality. Resection of the whole biliary tree by liver transplantation...

  • Long-term survival of a patient with common bile duct cancer after Virchow's node recurrence: Report of a case. Ochiai, Toshiya; Ikoma, Hisashi; Inoue, Koji; Komatsu, Shuhei; Murayama, Yasutoshi; Shiozaki, Atsushi; Kuriu, Yoshiaki; Nakanishi, Masayoshi; Ichikawa, Daisuke; Fujiwara, Hitoshi; Okamoto, Kazuma; Kokuba, Yukihito; Sonoyama, Teruhisa; Otsuji, Eigo // Surgery Today;Oct2011, Vol. 41 Issue 10, p1432 

    A 62-year-old male patient with common bile duct (CBD) cancer underwent pancreaticoduodenectomy with lymphadenectomy in 2002. Histological examinations revealed moderately differentiated tubular adenocarcinoma with lymph node metastasis around the pancreas head and hepatoduodenal ligament. No...

  • Liver parenchymal sparing surgery for locally advanced gallbladder cancer with extracapsular lymph node invasion. Masato Narita; Ryo Matsusue; Hiroaki Hata; Takashi Yamaguchi; Tetsushi Otani; Iwao Ikai // World Journal of Surgical Oncology;2014, Vol. 12 Issue 1, p2 

    A complete R0 resection is the standard treatment in patients with gallbladder cancer and the only potentially definitive curative therapy. Major hepatectomy, including right or extended right hepatectomy with extrahepatic bile duct resection, would be an option in patients with locally advanced...

  • Preoperative Embolization of the Common Hepatic Artery for Radical Surgery of Extrahepatic Cholangiocarcinoma. Sasaki, Yoshiyuki; Osada, Shinji; Kondo, Hiroshi; Goshima, Satoshi; Tokumaru, Yoshihisa; Yasufuku, Itaru; Kanematsu, Masayuki; Yoshida, Kazuhiro // American Surgeon;Dec2011, Vol. 77 Issue 12, pE269 

    The article presents the case of a 69-year-old man with embolization of common hepatic artery arising from the superior mesenteric artery performed before pancreatoduodenectomy. It says that the patient was found with increased wall thickness and enhancement of the gallbladder neck and cystic...

  • Incidence of benign disease in patients that underwent resection for presumed pancreatic cancer diagnosed by endoscopic ultrasonography (EUS) and fine-needle aspiration (FNA). de la Fuente, Sebastian G.; Ceppa, Eugene P.; Reddy, Srinevas K.; Clary, Bryan M.; Tyler, Douglas S.; Pappas, Theodore N. // Journal of Gastrointestinal Surgery;Jul2010, Vol. 14 Issue 7, p1139 

    Introduction: The lack of accurate markers makes preoperative differentiation between pancreatic cancer and non-malignant head lesions clinically challenging. In this study, we investigated the incidence of benign disease in patients that underwent resection for presumed pancreatic...

  • Clinical Significance of Lymph Node Micrometastasis in Ampullary Carcinoma. Sakata, Eiko; Shirai, Yoshio; Yokoyama, Naoyuki; Wakai, Toshifumi; Sakata, Jun; Hatakeyama, Katsuyoshi // World Journal of Surgery;Jun2006, Vol. 30 Issue 6, p985 

    Background: This study aimed to clarify the clinical significance of lymph node micrometastasis in ampullary carcinoma. Materials and Methods: Pancreaticoduodenectomy with regional lymphadenectomy was performed for 50 consecutive patients with ampullary carcinoma. A total of 1,283 regional lymph...

  • Cholangiocarcinoma metastatic to the neck: First report of a case. Hardeman, Scott H.; Collins, Brian; Lowe, Val J.; Solomon, Harvey; Stack Jr., Brendan C. // ENT: Ear, Nose & Throat Journal;Nov2002, Vol. 81 Issue 11, p776 

    We describe a unique case of a cholangiocarcinoma that metastasized to a cervical lymph node--to our knowledge the only such case ever reported. The diagnosis was based on fine-needle aspiration cytology and confirmed by excision biopsy. This case illustrates the importance of keeping all...

  • Survival of Proper Hepatic Artery Lymph Node Metastasis in Patients with Gastric Cancer: Implications for D2 Lymphadenectomy. Shirong, Cai; Jianhui, Chen; Chuangqi, Chen; Kaiming, Wu; Xinhua, Zhang; Wu, Song; Yulong, He // PLoS ONE;Mar2015, Vol. 10 Issue 3, p1 

    Background and Aims: There is a discrepancy between the American Joint Committee on Cancer (AJCC) guidelines (7th edition) and the Japanese treatment guidelines (3rd edition) with regard to the extent of D2 lymphadenectomy for gastric cancer. In the AJCC, hepatic artery station (No.12a) lymph...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics