title: Does an aberrant right hepatic artery really influence the short- and long-term results of a pancreaticoduodenectomy for malignant disease? A matched case-controlled study.
abstract: BACKGROUND
  An aberrant right hepatic artery (ARHA) is a common anatomic variation. The risk associated with ARHA during pancreaticoduodenectomy (PD) continues to be debated. The aim of this study was to compare the clinical outcomes and survival after PD with ARHA against a matched cohort of patients without ARHA.
  
  
  METHODS
  PD with an ARHA performed between January 2000 and September 2009 were retrospectively analyzed. Patients with an ARHA (group 1) were matched (1:2) to patients without an ARHA (group 2) according to gender, age, body mass index, type of tumor, and lymph node status. Peri- and postoperative outcomes were compared between the two groups. Overall survival and disease-free survival were estimated by Kaplan-Meier method and compared with log-rank test.
  
  
  RESULTS
  A total of 29 patients (group 1) and 55 patients (group 2) were compared. In group 1, an ARHA entered the tumor in six cases (20.7%), was sacrificed in four cases, and repaired in two cases. There was no difference regarding the rate of intraoperative and postoperative variables between the two groups. The oncological clearance (P = 0.731) and survival (overall survival, P = 0.843; disease-free survival, P = 0.832) were also similar.
  
  
  CONCLUSIONS
  Our study showed that the presence of an ARHA during PD was not associated with worse postoperative outcomes or survival.
authors.affiliation: Service de Chirurgie Hépatobiliaire et Digestive, Hôpital Pontchaillou, Centre Hospitalier Universitaire, Université de Rennes 1, Rennes, France; Inserm, UMR991, Foie, Métabolismes et Cancer, Université de Rennes 1, Rennes, France. Electronic address: laurent.sulpice@chu-rennes.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Sulpice
authors.forename: Michel
authors.initials: M
authors.lastname: Rayar
authors.forename: Cyrielle
authors.initials: C
authors.lastname: Paquet
authors.forename: Damien
authors.initials: D
authors.lastname: Bergeat
authors.forename: Aude
authors.initials: A
authors.lastname: Merdrignac
authors.forename: Diane
authors.initials: D
authors.lastname: Cunin
authors.forename: Bernard
authors.initials: B
authors.lastname: Meunier
authors.forename: Karim
authors.initials: K
authors.lastname: Boudjema
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000601:surgery; D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000601:surgery; D016022:Case-Control Studies; D018281:Cholangiocarcinoma / Q000401:mortality / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006499:Hepatic Artery / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000401:mortality*; D011183:Postoperative Complications / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Aberrant right hepatic artery; Outcomes; Pancreaticoduodenectomy; Survival