Prepancreatic common hepatic artery arising from superior mesenteric artery: an exceptional but important finding during pancreaticoduodenectomy.

Cinelli, Lorenzo; Felli, Eric; Muttillo, Edoardo Maria; Fiorentini, Guido; Diana, Michele; Pessaux, Patrick; Felli, Emanuele (2021). Prepancreatic common hepatic artery arising from superior mesenteric artery: an exceptional but important finding during pancreaticoduodenectomy. Surgical and radiologic anatomy, 43(9), pp. 1413-1420. Springer 10.1007/s00276-021-02786-7

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PURPOSE

The hepato-mesenteric trunk is an extremely rare condition in which the common hepatic artery (CHA) originates from the superior mesenteric artery (SMA). Usually, CHA passes behind the head of the pancreas. A systematic review was performed to provide guidelines for the perioperative management of patients with this anatomical variation who underwent a pancreaticoduodenectomy (PD). A case report was also included.

METHODS

A systematic search of the literature was conducted and the manuscript was structured following point-by-point the PRISMA guidelines. The risk of bias within individual studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist tools. Case report was structured according to the CARE guidelines.

RESULTS

After an initial selection of 141 titles, 9 articles were included in the study (n = 10 patients). A postoperative surgical complication which required a reintervention occurred only one time. In four patients, CHA had a posterior position relative to pancreas, while in three cases, it was anterior. The remaining three patients had an intrapancreatic course. The CHA was resected in two patients, with an end-to-end reconstruction or using the splenic artery stump. In only three patients, a preoperative multidisciplinary presentation was performed and in four cases, the CHA variation was not described by radiologists in formal CT-scan reports.

CONCLUSION

Although there are no definitive guidelines, improvements in the preoperative knowledge of such a rare anatomical variation may ensure better postoperative outcomes, avoiding intraoperative accidents and life-threatening postoperative complications.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie

UniBE Contributor:

Felli, Eric

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0930-1038

Publisher:

Springer

Language:

English

Submitter:

Rahel Fuhrer

Date Deposited:

09 Nov 2021 08:16

Last Modified:

05 Dec 2022 15:53

Publisher DOI:

10.1007/s00276-021-02786-7

PubMed ID:

34117902

Uncontrolled Keywords:

Case report Common hepatic artery Hepato-mesenteric trunk Pancreaticoduodenectomy Superior mesenteric artery Systematic review

BORIS DOI:

10.48350/160351

URI:

https://boris.unibe.ch/id/eprint/160351

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