Awareness of hepatic arterial variants is required in surgical oncology decision making strategy: Case report and review of literature

Sitarz,Robert; Berbecka,Monika; Mielko,Jerzy; Rawicz‑Pruszyński,Karol; Staśkiewicz,Grzegorz; Maciejewski,Ryszard; Polkowski,Wojciech

doi:10.3892/ol.2018.8106

May-2018 Volume 15 Issue 5

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May-2018 Volume 15 Issue 5

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Case Report Open Access

Awareness of hepatic arterial variants is required in surgical oncology decision making strategy: Case report and review of literature

Authors:
- Robert Sitarz
- Monika Berbecka
- Jerzy Mielko
- Karol Rawicz‑Pruszyński
- Grzegorz Staśkiewicz
- Ryszard Maciejewski
- Wojciech Polkowski
View Affiliations / Copyright

Affiliations: Department of Surgical Oncology, Medical University of Lublin, 20‑081 Lublin, Poland, Department of Human Anatomy, Medical University of Lublin, 20‑081 Lublin, Poland

Copyright: © Sitarz et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 6251-6256
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Published online on: February 22, 2018

https://doi.org/10.3892/ol.2018.8106
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Abstract

Surgery for the treatment of pancreatic cancer remains the gold standard, however, the identification of the vascular supply of the pancreas and the nearby organs remains a crucial difficulties in a curative resection. During pancreatic head resection for carcinoma dissection of regional arterial vasculature is mandatory. Normal coeliac and hepatic arterial anatomy occurs in ~50‑70% of patients and multiple variations have been described. Knowledge of multiple arterial anomalies is essential in hepato‑pancreatico‑billary surgery to avoid unnecessary complications. The present study presents coeliac trunk and common hepatic artery (CHA) anomalies along with their clinical importance, as reviewed according to the available literature. Patients diagnosed with cancer of the pancreatic head were hospitalized for staging and planning of radical surgical therapy. Computed tomography (CT) revealed a large tumour mass in the head of the pancreas and CHA, which branched directly from the superior mesenteric artery. A three‑dimensional CT reconstruction revealed a demonstrative vascular anomaly, which was confirmed during an operation. Despite the anomalous origin of the CHA, pylorus preserving pancreatoduodenectomy and regional lymph node dissection without intraoperative complications was performed in each case. The patient's postoperative clinical course was uneventful and adjuvant chemotherapy could be administered without delay. In the multidisciplinary treatment of pancreatic carcinoma the surgeon and radiologist must be aware of the aberrant anatomy in order to avoid potential complications. As CT scans used for the preoperative staging are of diagnostic value for vascular anomaly, it is required for appropriate surgical decision making.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Awareness of hepatic arterial variants is required in surgical oncology decision making strategy: Case report and review of literature

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