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01-03-2018 | ORIGINAL ARTICLE

Outcome of concomitant resection of the replaced right hepatic artery in pancreaticoduodenectomy without reconstruction

Authors: Toshimichi Asano, Toru Nakamura, Takehiro Noji, Keisuke Okamura, Takahiro Tsuchikawa, Yoshitsugu Nakanishi, Kimitaka Tanaka, Soichi Murakami, Yuma Ebihara, Yo Kurashima, Toshiaki Shichinohe, Satoshi Hirano

Published in: Langenbeck's Archives of Surgery | Issue 2/2018

Abstract

Purpose

It has been reported that preoperative embolization or intraoperative reconstruction of the replaced right hepatic artery (rRHA) in order to secure the arterial blood flow to the liver and biliary tract are useful for patients who have undergone pancreaticoduodenectomy (PD) with concomitant rRHA resection. In this study, the feasibility of concomitant resection of rRHA in PD without preoperative embolization or intraoperative reconstruction were retrospectively evaluated with a particular focus on postoperative complications.

Methods

We retrospectively analyzed 323 consecutive patients who underwent PD.

Results

In 51 patients (15.8%), an rRHA was detected. Nine of 51 patients underwent combined rRHA resection during PD. Eight patients showed tumor abutment, and one patient had accidental intraoperative damage of the rRHA. Although there were no cases of bilioenteric anastomotic failure, a hepatic abscess occurred in one patient. This patient was treated with percutaneous transhepatic abscess drainage and was cured immediately without suffering sepsis. Postoperative complications of Clavien-Dindo classification ≥ IIIa were found in three patients, and R0 resection was achieved in six. Surgical outcomes showed no significant differences between the rRHA-resected and non-resected groups. Moreover, there were no significant differences in laboratory data related to liver functions between the rRHA-resected and non-resected groups before surgery and on postoperative days 1, 3, 5, and 7.

Conclusions

Simple resection of the rRHA following an unintended or accidental injury during PD is not associated with severe morbidity and should be considered as an alternative to a technically difficult reconstruction.

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Title: Outcome of concomitant resection of the replaced right hepatic artery in pancreaticoduodenectomy without reconstruction
Authors: Toshimichi Asano
Toru Nakamura
Takehiro Noji
Keisuke Okamura
Takahiro Tsuchikawa
Yoshitsugu Nakanishi
Kimitaka Tanaka
Soichi Murakami
Yuma Ebihara
Yo Kurashima
Toshiaki Shichinohe
Satoshi Hirano
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 2/2018
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-018-1650-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Outcome of concomitant resection of the replaced right hepatic artery in pancreaticoduodenectomy without reconstruction

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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