Dealing with hepatic artery traumas: A clinical literature review

Table 2 Selected and summarized hepatic artery injury, ligation, resection, or embolization series in the literature

Ref.	Cases, n	Etiology	Anomaly	HA injuries (laceration/transection, ligation/embolization)	Treatment options ligation/embolization reconstruction	Morbidity, n	Mortality, 90-d
Edgecombe and Gardner[2]	40	Review of the literature including cholecystectomy aneurysm and EHBT tumor	NA	40 ligation	Ligation? Drainage	LF? LA?	50%-75%
Brittain et al[16]	5	Cholecystectomy	NA	5 injury/ligation	No reconstruction, drainage	1% LA	1%
Alves et al[15]	55	Postcholecystectomy biliary tract stricture series (Bismuth type 3-4-5)	20?	20 rRHA/RHA injury?, 2 HA pseudoaneurism, 4 portal vein injury	43 HJ, 12 right Hx	1% LA, 12% atrophy	NA
Stewart et al[10]	261	Biliary tract injury during LC	NA	84 RHA injury	4 Hx, HJ, drainage	12% LA, 9% LN, 17% bleeding, 7% hemobilia, …	2%
Gaujoux et al[24]	545	PD series	NA	4 injury (Postoperative detection)	4 (Thrombectomy, stenting, reconstruction) 2 left Hx	2% LN, 4% thrombosis, 1% HJ	3%
Tzeng et al[14]	32	Liver trauma (15) + Interventional HA injury (17)	NA	32 injury	32 Embolization (2 fail)	2% LA, drainage	-
Li et al[12]	60	Biliary tract injury during LC	NA	8 RHA injury; 2 PHA injury	5 Reconstruction (2 fail)	3 LN, 3 Hx, 2 LA, 3 others	3%
Turrini et al[53]	471	PD series	47	1 injury? 2 planned resection	2 Reconstruction	-	-
Eshuis et al[9]	758	PD series	143	8 planned resection, 5 injury	3 Reconstruction	3 PF, 4 DGE, 1 LA, 3 Rlp	2%
Okada et al[52]	180	PD series	25	6 preop embolization and planned resection	No-reconstruction	1 POPF	-
El Amrani et al[27]	2278	Systematic analysis for PD (1950-2014)	440	49 injury; 6 embolization (preop)	18 Reconstruction	POPF 15%, DGE 39%,	0%-10%
Landen et al[3]	NA	Systematic review for PD (1990-2016)	3	21 injury (8 PHA, 3 RHA, 3 rRHA, 4 HA thrombosis, 3 HA injury)	5 Reconstruction (1 fail)	14 LA, 3 LF, 6 AL,11 Rlp	5 (24%)
Asano et al[19]	343	PD series	51	1 rRHA injury; 8 rRHA planned resection	No reconstruction; 1 drainage	1 LA	-
Kleive et al[20]	1535	Pancreatectomy series	NA	14 injury (5 SMA, 5 RHA, 2 CHA, 2 Celiac trunk); 22 planned resection	Embolectomy, Hx, re-reconstruction, drainage	4 thrombosis, 2 PPH, 1 POPF, 5 LN, 11 Rlp	2 injured; 1 planned
Elsanousi et al[34]	19	Invasive HCC series	NA	19 HALED	19 HALED1	8 Ascites-controlled, 2 jaundice	1 Pulmonary embolism

¹Ligation for therapeutic purpose.

Three patients died of LA at postoperative 5-7-12 mo. AL: anastomotic leakage; CHA: common HA; DGE: delayed gastric emptying; EHBT: Extrahepatic bile tract; HJ: Hepp-Couinaud hepaticojejunostomy; Hx: Hepatectomy, HALED: Hepatic artery ligation and extrahepatic collateral division; LA: Liver abscess; LC: Laparoscopic cholecystectomy; LF: Liver failure, LHA: Left HA; LN: Liver necrosis; n: Number of cases in series; NA: Not available; PD: Pancreaticoduodenectomy; POPF: Postoperative pancreatic fistula; PHA: Proper hepatic artery; PPH: Post pancreatectomy haemorrhage; Rlp: Relaparotomy; rRHA: Replaced right hepatic artery; SMA: Superior mesenteric artery.