Related Experiment Video
Updated: Apr 18, 2026
Robot Assisted Distal Pancreatectomy with Celiac Axis Resection DP-CAR for Pancreatic Cancer: Surgical Planning and Technique
Published on: August 14, 2021
Accuracy of routine multidetector computed tomography to identify arterial variants in patients scheduled for
1Feng Yang, Yang Di, Ji Li, Xiao-Yi Wang, Lie Yao, Si-Jie Hao, Yong-Jian Jiang, Chen Jin, De-Liang Fu, Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China.
Insights
Routine multidetector computed tomography (MDCT) effectively identifies aberrant right hepatic artery (RHA) and celiac artery stenosis (CAS) in patients undergoing pancreaticoduodenectomy. This imaging is crucial for surgical planning and preventing complications.
Area of Science:
- Radiology
- Vascular Imaging
- Surgical Oncology
Background:
- Pancreaticoduodenectomy requires detailed preoperative assessment of visceral arteries.
- Aberrant right hepatic artery (RHA) and celiac artery stenosis (CAS) are significant vascular variations impacting surgical approach.
- Multidetector computed tomography (MDCT) is a standard preoperative imaging modality.
Purpose of the Study:
- To evaluate the diagnostic performance of MDCT without arterial reconstruction.
- To identify aberrant RHA and CAS in patients undergoing pancreaticoduodenectomy.
- To determine the accuracy, sensitivity, and specificity of MDCT for these vascular anomalies.
Main Methods:
- Retrospective analysis of 458 patients for RHA and 181 for CAS.
- MDCT imaging data were reviewed without arterial reconstruction.
- Computed tomography angiography (CTA), conventional angiography, and surgical findings served as reference standards.
Main Results:
- MDCT demonstrated high accuracy (98.5%), sensitivity (96.3%), and specificity (98.8%) for aberrant RHA detection.
- For CAS detection, MDCT showed a sensitivity of 58.3%, specificity of 98.2%, positive predictive value of 70%, and negative predictive value of 97.1%.
- Aberrant RHA was found in 11.8% and CAS in 6.6% of the evaluated patients.
Conclusions:
- Routine preoperative MDCT is effective in identifying aberrant RHA and CAS.
- Radiologists and surgeons should be aware of these arterial variants on preoperative CT scans.
- MDCT findings can guide surgical planning and potentially reduce operative risks.
Aim:
To assess the efficacy of cross-sectional multidetector computed tomography (MDCT) imaging without arterial reconstruction to identify aberrant right hepatic artery (RHA) and celiac artery stenosis (CAS) in patients scheduled for pancreaticoduodenectomy.
Methods:
Patients with peri-ampullary and pancreatic head tumors who underwent routine preoperative MDCT and subsequent computed tomography (CT) angiography (CTA), conventional angiography or pancreaticoduodenectomy between September 2007 and August 2013 were identified. Retrospective analysis of imaging data was undertaken using CTA, conventional angiographic and surgical findings as the reference standards. The accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MDCT in evaluation of aberrant RHA and CAS were calculated.
Results:
A group of 458 patients met the inclusion criteria of this study to detect aberrant RHA, and 181 cases were included to identify CAS. Fifty-four (11.8%) patients were confirmed to have aberrant RHA, while 12 (6.6%) patients with CAS were demonstrated. MDCT yielded an accuracy of 98.5%, sensitivity of 96.3% and specificity of 98.8% in the detection of aberrant RHA. The sensitivity, specificity, PPV and NPV of MDCT for detecting CAS were 58.3%, 98.2%, 70% and 97.1%, respectively.
Conclusion:
Routine MDCT is recommended such that surgeons and radiologists be alerted to the importance of arterial variants on preoperative CT scans in patients scheduled for pancreaticoduodenectomy.
