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
ARTICLE HIGHLIGHTS
Research background

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 (LGA).

Research motivation

A previous study, comparing LAG with laparoscopy-assisted colectomy, found that liver dysfunction might not be caused by carbon dioxide pneumoperitoneum. According to existing studies, there is still controversy regarding whether ALHA should be ligated during LAG surgery, and whether liver dysfunction occurs when ALHA is ligated.

Research objectives

The purpose of this systematic review is to summarize and assess the safety and feasibility of ALHA ligation in GC patients who underwent LAG surgery.

Research 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.

Research results

A total of nine studies were included in this review. 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.

Research conclusions

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.

Research perspectives

More large-scale studies and randomized controlled trials clarifying the relationship between ALHA ligation and LAG surgery in postoperative liver function variations in GC patients are needed in the future.