Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2022; 10(10): 3121-3130
Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3121
Clinical significance of aberrant left hepatic artery during gastrectomy: A systematic review
Wei Tao, Dong Peng, Yu-Xi Cheng, Wei Zhang
Wei Tao, Dong Peng, Yu-Xi Cheng, Wei Zhang, Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Author contributions: Tao W and Peng D contributed equally to this work; Zhang W designed the research study; Tao W wrote the manuscript; Peng D and Cheng YX conducted data extraction; Tao W conducted figure painting; Tao W, Peng D, Cheng YX and Zhang W conducted writing review and editing; all authors read and approved the final manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
PRISMA 2009 Checklist statement: This systematic review was designed and performed based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Zhang, PhD, Surgeon, Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuanjiagang, Yuzhong Distric, Chongqing 400016, China. cyzhangwei@hotmail.com
Received: September 27, 2021
Peer-review started: September 27, 2021
First decision: December 2, 2021
Revised: December 12, 2021
Accepted: February 20, 2022
Article in press: February 20, 2022
Published online: April 6, 2022
Processing time: 182 Days and 20.2 Hours
Abstract
BACKGROUND

Vascular variations are frequently encountered during surgery. Approximately thirty percent of these variations are aberrant left hepatic arteries originating from the left gastric artery.

AIM

To summarize the safety and feasibility of aberrant left hepatic arteries (ALHA) ligation in gastric cancer patients who underwent laparoscopic-assisted gastrectomy (LAG).

METHODS

The literature search was systematically performed on databases including PubMed, Embase, and Cochrane Library. The publishing date of eligible studies was from inception to June 2021.

RESULTS

A total of nine studies were included according to the inclusion and exclusion criteria in this review. The variation rate of ALHA ranged from 7.00% to 20.70%, and four studies compared the differences between the ALHA ligation group and the preservation group. Only one study showed worse postoperative outcomes in the ALHA ligation group. In all the included studies, a significant difference was found between the ALHA ligation group and the preservation group in terms of postoperative liver enzymes after LAG. However, there was no significant difference in the number of retrieved lymph nodes between the two groups.

CONCLUSION

In conclusion, it is not always safe and feasible for surgeons to ligate the ALHA during LAG surgery, and it is necessary for gastric cancer patients to undergo preoperative examination to clarify the ALHA subtypes, measure the diameter of the ALHA, and determine whether the patients have chronic liver disease.

Keywords: Gastric cancer; Aberrant left hepatic artery; Laparoscopic-assisted gastrectomy; Vascular variation; Ligation

Core Tip: Vascular variations are frequently encountered during surgery. Approximately thirty percent of these variations are aberrant left hepatic arteries (ALHAs) originating from the left gastric artery. And liver dysfunction occurs more frequently after laparoscopic-assisted gastrectomy (LAG). The purpose of this systematic review is to summarize the safety and feasibility of ALHA ligation in gastric cancer patients who underwent LAG.