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Implications of the presence of an aberrant right hepatic artery in patients undergoing pancreaticoduodenectomy

Implications of the presence of an aberrant right hepatic artery in patients undergoing pancreaticoduodenectomy

作     者:Ashwin Rammohan Ravichandran Palaniappan Anbalagan Pitchaimuthu Kamalakannan Rajendran Senthil Kumar Perumal Kesavan Balaraman Ravi Ramasamy Jeswanth Sathyanesan Manoharan Govindan 

作者机构:The Institute of Surgical Gastroenterology and Liver Transplantation Centre for GI Bleed Division of HPB diseases Stanley Medical College Hospital 

出 版 物:《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志(英文版)(电子版))

年 卷 期:2014年第6卷第1期

页      面:9-13页

学科分类:1002[医学-临床医学] 100210[医学-外科学(含:普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主  题:Pancreatoduodenectomy Aberrant right hepatic artery Arterial anomalies Outcomes 

摘      要:AIM:To analyze the differences in outcomes and the clinical impact following pancreatoduodenectomy(PD)in patients with and without aberrant right hepatic artery(aRHA).METHODS:All patients undergoing PD between January 2008 and December 2012 were divided into two groups,one with aRHA and the other *** groups were compared to identify differences in the intraoperative variables,the oncological clearance and the postoperative morbidity,mortality and hospital ***:A total of 225 patients underwent PD,of which 43(19.1%)patients were found to have eitheraccessory or replaced right hepatic arteries(aRHA group).The aRHA was preserved in 79%of the *** was no significant difference in the intraoperative blood loss but operative time was prolonged,reflecting the complexity of the procedure[420±44(240-540)min vs 480±45(300-600)min,P0.05)].There were no differences in the incidence of postoperative complications(pancreatic leak,pancreatic fistula,delayed gastric emptying and mortality)and hospital *** clearance in the form of positive resection margins[13(7.1%)vs 3(6.9%)]and lymph node yield were also similar in the two ***:An aRHA is found in approximately one fifth of patients undergoing *** is technically possible in most patients and can increase the operative complexity but does not negatively affect the safety or oncological outcomes of the procedure.

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