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

  • Published online on: February 22, 2018     https://doi.org/10.3892/ol.2018.8106
  • Pages: 6251-6256
  • Copyright: © Sitarz et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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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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May-2018
Volume 15 Issue 5

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Sitarz R, Berbecka M, Mielko J, Rawicz‑Pruszyński K, Staśkiewicz G, Maciejewski R and Polkowski W: Awareness of hepatic arterial variants is required in surgical oncology decision making strategy: Case report and review of literature. Oncol Lett 15: 6251-6256, 2018
APA
Sitarz, R., Berbecka, M., Mielko, J., Rawicz‑Pruszyński, K., Staśkiewicz, G., Maciejewski, R., & Polkowski, W. (2018). Awareness of hepatic arterial variants is required in surgical oncology decision making strategy: Case report and review of literature. Oncology Letters, 15, 6251-6256. https://doi.org/10.3892/ol.2018.8106
MLA
Sitarz, R., Berbecka, M., Mielko, J., Rawicz‑Pruszyński, K., Staśkiewicz, G., Maciejewski, R., Polkowski, W."Awareness of hepatic arterial variants is required in surgical oncology decision making strategy: Case report and review of literature". Oncology Letters 15.5 (2018): 6251-6256.
Chicago
Sitarz, R., Berbecka, M., Mielko, J., Rawicz‑Pruszyński, K., Staśkiewicz, G., Maciejewski, R., Polkowski, W."Awareness of hepatic arterial variants is required in surgical oncology decision making strategy: Case report and review of literature". Oncology Letters 15, no. 5 (2018): 6251-6256. https://doi.org/10.3892/ol.2018.8106