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Replaced Right Hepatic Artery Arising from the Gastroduodenal Artery: a Rare and Challenging Anatomical Variant of the Whipple Procedure


Pueyo-Périz, Eva María; Sánchez-Velázquez, Patricia; De Miguel, Maite; Radosevic, Aleksandar; Petrowsky, Henrik; Burdío, Fernando (2020). Replaced Right Hepatic Artery Arising from the Gastroduodenal Artery: a Rare and Challenging Anatomical Variant of the Whipple Procedure. Journal of Surgical Case Reports, 2020(6):rjaa136.

Abstract

Accurate assessment of the vascular anatomy is a prerequisite of any pancreatic resection, since an unnoticed arterial injury in the context of a complex resection such as Whipple procedure, can seriously jeopardize patient’s safety. This article aims to describe an infrequent anatomic variant of a replaced right hepatic artery originating directly from the gastroduodenal artery and its potential implications for duodenopancreatectomy, as the gastroduodenal artery is routinely divided. We present here two different cases of this arterial abnormality identified during a Whipple procedure and its implications in each different setting. Preoperative identification of anatomical variations is essential for proficient surgical planning. Nevertheless, when detected during surgery, an meticulous dissection of the hepatoduodenal ligament is required to identify all the vascular relations in order to avoid irreversible damage.

Abstract

Accurate assessment of the vascular anatomy is a prerequisite of any pancreatic resection, since an unnoticed arterial injury in the context of a complex resection such as Whipple procedure, can seriously jeopardize patient’s safety. This article aims to describe an infrequent anatomic variant of a replaced right hepatic artery originating directly from the gastroduodenal artery and its potential implications for duodenopancreatectomy, as the gastroduodenal artery is routinely divided. We present here two different cases of this arterial abnormality identified during a Whipple procedure and its implications in each different setting. Preoperative identification of anatomical variations is essential for proficient surgical planning. Nevertheless, when detected during surgery, an meticulous dissection of the hepatoduodenal ligament is required to identify all the vascular relations in order to avoid irreversible damage.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Visceral and Transplantation Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 June 2020
Deposited On:08 Feb 2021 16:00
Last Modified:10 Feb 2021 07:04
Publisher:JSCR Publishing
ISSN:2042-8812
OA Status:Gold
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1093/jscr/rjaa136
PubMed ID:32582432

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