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Esophagogastrectomy and the variant left hepatic artery
A W Hemming1, R J Finley, K G Evans
1Department of Surgery, University of British Columbia, Vancouver, Columbia.
The Annals of Thoracic Surgery
|July 1, 1992
Summary
Aberrant left hepatic arteries are common and can cause fatal hepatic necrosis if sacrificed during esophagogastrectomy. This study presents a method to safely perform esophagogastrectomy with this arterial variant.
Area of Science:
- Surgical Anatomy
- Gastrointestinal Surgery
- Vascular Anatomy
Background:
- A variant left hepatic artery (LHA) arises in approximately 10% of individuals.
- Standard esophagogastrectomy and proximal gastric procedures often involve sacrificing the aberrant LHA.
- Sacrificing the aberrant LHA can lead to severe complications, including hepatic necrosis and fatalities.
Purpose of the Study:
- To describe a surgical technique for esophagogastrectomy that preserves an aberrant left hepatic artery.
- To reduce the risk of hepatic necrosis and associated mortality in patients undergoing esophagogastric surgery with this vascular anomaly.
Main Methods:
- Detailed description of the modified esophagogastrectomy technique.
- Intraoperative identification and management of the aberrant left hepatic artery.
- Case illustration of the described surgical approach.
Main Results:
- Successful preservation of the aberrant left hepatic artery during esophagogastrectomy.
- Absence of hepatic necrosis or other major vascular complications in the reported case(s).
- Demonstration of the feasibility and safety of the described technique.
Conclusions:
- Esophagogastrectomy can be safely performed in the presence of an aberrant left hepatic artery using a modified technique.
- Preservation of the aberrant LHA is crucial to prevent postoperative hepatic complications.
- This approach offers a viable solution for managing patients with this common arterial variant undergoing upper gastrointestinal surgery.