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Aberrant left hepatic artery in laparoscopic antireflux procedures
P J Klingler1, M H Seelig, N R Floch
1Department of Surgery, Mayo Clinic Jacksonville, Jacksonville, FL, USA.
Surgical Endoscopy
|April 1, 2004
Summary
Aberrant left hepatic artery (ALHA) is found in nearly 8% of patients undergoing laparoscopic antireflux surgery. Division of ALHA may be necessary but does not lead to long-term liver complications.
Area of Science:
- Gastrointestinal surgery
- Surgical anatomy
- Hepatic artery variations
Background:
- Aberrant left hepatic artery (ALHA) is an anatomical variation that can complicate laparoscopic antireflux procedures.
- Understanding the frequency and implications of ALHA is crucial for surgical planning.
Purpose of the Study:
- To determine the incidence of ALHA in patients undergoing laparoscopic antireflux surgery.
- To identify reasons for ALHA division during surgery.
- To evaluate the outcomes following ALHA division.
Main Methods:
- Prospective data collection from 720 patients undergoing laparoscopic antireflux surgery.
- Analysis of ALHA presence, clinical data, operative reports, and follow-up.
- Evaluation of surgical complications and patient outcomes post-division.
Main Results:
- ALHA was identified in 7.9% of patients.
- Division was required in 29.8% of cases due to impaired hiatal dissection; bleeding necessitated division in 1.8%.
- No patients experienced long-term liver dysfunction, though transiently elevated liver enzymes occurred in 11.7%.
Conclusions:
- ALHA is a relatively common finding in laparoscopic antireflux surgery.
- Division of ALHA, when necessary for surgical access or bleeding control, is safe.
- Patients typically do not suffer clinical consequences, but temporary liver enzyme elevation is possible.
