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World J Gastrointest Surg. Jan 27, 2014; 6(1): 9-13
Published online Jan 27, 2014. doi: 10.4240/wjgs.v6.i1.9
Published online Jan 27, 2014. doi: 10.4240/wjgs.v6.i1.9
Implications of the presence of an aberrant right hepatic artery in patients undergoing pancreaticoduodenectomy
Ashwin Rammohan, Ravichandran Palaniappan, Anbalagan Pitchaimuthu, Kamalakannan Rajendran, Senthil Kumar Perumal, Kesavan Balaraman, Ravi Ramasamy, Jeswanth Sathyanesan, Manoharan Govindan, The Institute of Surgical Gastroenterology and Liver Transplantation, Centre for GI Bleed, Division of HPB diseases, Stanley Medical College Hospital, Chennai 600 001, India
Author contributions: Rammohan A, Palaniappan R, Pitchaimuthu A, Rajendran K and Perumal SK contributed to the conception and design, acquisition, analysis and interpretation of data; Rammohan A, Balaraman K, Ramasamy R and Sathyanesan J drafted the article and revised it critically for important intellectual content; Sathyanesan J, Palaniappan R and Govindan M gave the final approval of the version to be published.
Correspondence to: Dr. Ashwin Rammohan, The Institute of Surgical Gastroenterology and Liver Transplantation, Centre for GI Bleed, Division of HPB diseases, Stanley Medical College Hospital, Old Jail Road, Chennai 600 001, India. ashwinrammohan@gmail.com
Telephone: +91-988-4173583 Fax: +91-44-25289595
Received: October 14, 2013
Revised: December 7, 2013
Accepted: December 17, 2013
Published online: January 27, 2014
Processing time: 105 Days and 15.9 Hours
Revised: December 7, 2013
Accepted: December 17, 2013
Published online: January 27, 2014
Processing time: 105 Days and 15.9 Hours
Core Tip
Core tip: Appreciation and study of hepatic arterial anatomical variability is essential to the successful performance of complex pancreaticobiliary procedures. An aberrant right hepatic artery (aRHA) represents the vascular anomaly encountered most frequently during pancreatoduodenectomy (PD) and, because of its course, is most susceptible to intraoperative damage and tumor involvement. When an aRHA is present, the challenge in peripancreatic malignant disease is to balance its preservation and the need to achieve oncological clearance. In this study, we analyzed the incidence of aRHA and its relationship with the operative complexity, occurrence of complications and oncological clearance in a large cohort of patients undergoing PD.