Vascular anatomy of the liver is varied,and the 'standard'anatomy is seen in 55%-80%of cases.It is very important that extrahepatic arteries are identified precisely at the time of graft procurement to avoid i...Vascular anatomy of the liver is varied,and the 'standard'anatomy is seen in 55%-80%of cases.It is very important that extrahepatic arteries are identified precisely at the time of graft procurement to avoid injuries that might compromise the liver function.In the present case the liver donor had the vascular anatomy of Michels typeⅦ,e.g.a hepatic artery originating from the celiac trunk and going to the left lobe,an accessory left hepatic artery coming from the left gastric artery,and a replaced right hepatic artery coming from the superior mesenteric artery.This pattern of vascular supply is uncommon,representing less than 5%of cases.The replaced hepatic artery was reconstructed in the back-table with polypropylene suture 7.0 by connecting it to the stump of the splenic artery,and the celiac trunk of the graft was anastomosed to the recipient common hepatic artery.展开更多
BACKGROUND Vascular variations are frequently encountered during surgery.Approximately thirty percent of these variations are aberrant left hepatic arteries originating from the left gastric artery.AIM To summarize th...BACKGROUND Vascular variations are frequently encountered during surgery.Approximately thirty percent of these variations are aberrant left hepatic arteries originating from the left gastric artery.AIM To summarize the safety and feasibility of aberrant left hepatic arteries(ALHA)ligation in gastric cancer patients who underwent laparoscopic-assisted gastrectomy(LAG).METHODS The literature search was systematically performed on databases including Pub Med,Embase,and Cochrane Library.The publishing date of eligible studies was from inception to June 2021.RESULTS A total of nine studies were included according to the inclusion and exclusion criteria in this review.The variation rate of ALHA ranged from 7.00%to 20.70%,and four studies compared the differences between the ALHA ligation group and the preservation group.Only one study showed worse postoperative outcomes in the ALHA ligation group.In all the included studies,a significant difference was found between the ALHA ligation group and the preservation group in terms of postoperative liver enzymes after LAG.However,there was no significant difference in the number of retrieved lymph nodes between the two groups.CONCLUSION In conclusion,it is not always safe and feasible for surgeons to ligate the ALHA during LAG surgery,and it is necessary for gastric cancer patients to undergo preoperative examination to clarify the ALHA subtypes,measure the diameter of the ALHA,and determine whether the patients have chronic liver disease.展开更多
文摘Vascular anatomy of the liver is varied,and the 'standard'anatomy is seen in 55%-80%of cases.It is very important that extrahepatic arteries are identified precisely at the time of graft procurement to avoid injuries that might compromise the liver function.In the present case the liver donor had the vascular anatomy of Michels typeⅦ,e.g.a hepatic artery originating from the celiac trunk and going to the left lobe,an accessory left hepatic artery coming from the left gastric artery,and a replaced right hepatic artery coming from the superior mesenteric artery.This pattern of vascular supply is uncommon,representing less than 5%of cases.The replaced hepatic artery was reconstructed in the back-table with polypropylene suture 7.0 by connecting it to the stump of the splenic artery,and the celiac trunk of the graft was anastomosed to the recipient common hepatic artery.
文摘BACKGROUND Vascular variations are frequently encountered during surgery.Approximately thirty percent of these variations are aberrant left hepatic arteries originating from the left gastric artery.AIM To summarize the safety and feasibility of aberrant left hepatic arteries(ALHA)ligation in gastric cancer patients who underwent laparoscopic-assisted gastrectomy(LAG).METHODS The literature search was systematically performed on databases including Pub Med,Embase,and Cochrane Library.The publishing date of eligible studies was from inception to June 2021.RESULTS A total of nine studies were included according to the inclusion and exclusion criteria in this review.The variation rate of ALHA ranged from 7.00%to 20.70%,and four studies compared the differences between the ALHA ligation group and the preservation group.Only one study showed worse postoperative outcomes in the ALHA ligation group.In all the included studies,a significant difference was found between the ALHA ligation group and the preservation group in terms of postoperative liver enzymes after LAG.However,there was no significant difference in the number of retrieved lymph nodes between the two groups.CONCLUSION In conclusion,it is not always safe and feasible for surgeons to ligate the ALHA during LAG surgery,and it is necessary for gastric cancer patients to undergo preoperative examination to clarify the ALHA subtypes,measure the diameter of the ALHA,and determine whether the patients have chronic liver disease.
