Various benign and malignant conditions could cause biliary obstruction. Compression of extrahepatic bile duct (EBD) by right hepatic artery was reported as a right hepatic artery syndrome but all cases were compresse...Various benign and malignant conditions could cause biliary obstruction. Compression of extrahepatic bile duct (EBD) by right hepatic artery was reported as a right hepatic artery syndrome but all cases were compressed EBD from stomach side. Our case compressed from dorsum was not yet reported, so it was thought to be a very rare case. We present here the first case of bile duct obstruction due to the compression of EBD from dorsum by right hepatic artery.展开更多
The right hepatic artery is an important arterial supply to right lobe of the liver. And the knowledge of the normal anatomy and anatomical variations of the right hepatic artery is essential to perfume, and will mini...The right hepatic artery is an important arterial supply to right lobe of the liver. And the knowledge of the normal anatomy and anatomical variations of the right hepatic artery is essential to perfume, and will minimize morbidity, and also help to decrease the number of complications of hepatobiliary surgery. This study was conducted on eleven human cadavers, which were obtained from the routine autopsies at the dissection room of the Anatomy Department. During dissection of the eleven cadaveric livers, we found a case with an ex-ceptional anatomic variation;a replaced right hepatic artery (RRHA) coming off the superior mesenteric artery (SMA), directly to the hepatic right lobe passing through the Calot’s triangle, crossing behind the common hepatic duct (CHD). <span style="font-family:Verdana;">Our objective is to draw much attention to this particularly anatomic variation of the origin of the RRHA as well as its clinical importance in order to ensure that no damage will be made during gastrointestinal and hepatobiliary surgery.</span>展开更多
The standard surgery for distal common bile duct adenocarcinoma,pancreatic adenocarcinoma,and ampullary adenocarcinoma is pancreaticoduodenectomy(PD).PD is a technically challenging procedure with high mortality(0-3.5...The standard surgery for distal common bile duct adenocarcinoma,pancreatic adenocarcinoma,and ampullary adenocarcinoma is pancreaticoduodenectomy(PD).PD is a technically challenging procedure with high mortality(0-3.5%)and morbidity(38-50%)rates(1-5).It is essential to recognize the anatomy preoperatively,especially of the hepatic artery and positions of the tumors,to avoid adverse events(6,7).The aberrant right hepatic artery(aRHA)originating from the superior mesenteric artery(SMA)is the most frequent and considerable hepatic artery variation(8-10).展开更多
Hepatobiliary pancreatic surgeons sometimes encounter an aberrant(or replaced)right hepatic artery(a-RHA,Hiatt types III-VI)during pancreaticoduodenectomy(PD).Arterial flow cutoff to the a-RHA may be associated with a...Hepatobiliary pancreatic surgeons sometimes encounter an aberrant(or replaced)right hepatic artery(a-RHA,Hiatt types III-VI)during pancreaticoduodenectomy(PD).Arterial flow cutoff to the a-RHA may be associated with a biliary leak or stenosis at the choledocho-jejunostomy and liver ischemia,resulting in ischemic cholangitis,liver abscess,and sepsis(1).展开更多
文摘Various benign and malignant conditions could cause biliary obstruction. Compression of extrahepatic bile duct (EBD) by right hepatic artery was reported as a right hepatic artery syndrome but all cases were compressed EBD from stomach side. Our case compressed from dorsum was not yet reported, so it was thought to be a very rare case. We present here the first case of bile duct obstruction due to the compression of EBD from dorsum by right hepatic artery.
文摘The right hepatic artery is an important arterial supply to right lobe of the liver. And the knowledge of the normal anatomy and anatomical variations of the right hepatic artery is essential to perfume, and will minimize morbidity, and also help to decrease the number of complications of hepatobiliary surgery. This study was conducted on eleven human cadavers, which were obtained from the routine autopsies at the dissection room of the Anatomy Department. During dissection of the eleven cadaveric livers, we found a case with an ex-ceptional anatomic variation;a replaced right hepatic artery (RRHA) coming off the superior mesenteric artery (SMA), directly to the hepatic right lobe passing through the Calot’s triangle, crossing behind the common hepatic duct (CHD). <span style="font-family:Verdana;">Our objective is to draw much attention to this particularly anatomic variation of the origin of the RRHA as well as its clinical importance in order to ensure that no damage will be made during gastrointestinal and hepatobiliary surgery.</span>
文摘The standard surgery for distal common bile duct adenocarcinoma,pancreatic adenocarcinoma,and ampullary adenocarcinoma is pancreaticoduodenectomy(PD).PD is a technically challenging procedure with high mortality(0-3.5%)and morbidity(38-50%)rates(1-5).It is essential to recognize the anatomy preoperatively,especially of the hepatic artery and positions of the tumors,to avoid adverse events(6,7).The aberrant right hepatic artery(aRHA)originating from the superior mesenteric artery(SMA)is the most frequent and considerable hepatic artery variation(8-10).
文摘Hepatobiliary pancreatic surgeons sometimes encounter an aberrant(or replaced)right hepatic artery(a-RHA,Hiatt types III-VI)during pancreaticoduodenectomy(PD).Arterial flow cutoff to the a-RHA may be associated with a biliary leak or stenosis at the choledocho-jejunostomy and liver ischemia,resulting in ischemic cholangitis,liver abscess,and sepsis(1).
