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Replaced gastroduodenal artery: Added benefit of the "artery first" approach during pancreaticoduodenectomy-A case report. Int J Surg Case Rep 2016;23:93-7

Date

04/29/2016

Pubmed ID

27124718

Pubmed Central ID

PMC4855750

DOI

10.1016/j.ijscr.2016.04.014

Scopus ID

2-s2.0-84964669792   6 Citations

Abstract

INTRODUCTION: Variations in hepatic arterial anatomy are frequently encountered in pancreas and liver surgery. These aberrancies add technical complexity to the procedure and can result in significant patient morbidity if these vascular nuances are not recognized.

PRESENTATION OF CASE: We report a case whereby a superior mesenteric artery first approach was used to locate and preserve an aberrant left hepatic artery arising from a replaced gastroduodenal artery emanating from the SMA during pancreaticoduodenectomy. The procedure was done for resection of a large duodenal adenoma.

DISCUSSION: High-quality preoperative imaging and mastery in surgical expertise are requirements for identification and preservation of aberrant hepatic arterial anatomy during procedures involving vital intra-abdominal organs.

CONCLUSION: Our aim is to provide awareness of rare vascular anomalies encountered during pancreaticoduodenectomy and provide a unique method for successful management.

Author List

Younan G, Chimukangara M, Tsai S, Evans DB, Christians KK

Authors

Kathleen K. Christians MD Professor in the Surgery department at Medical College of Wisconsin
Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin
Susan Tsai MD Professor in the Surgery department at Medical College of Wisconsin