title: First jejunal artery, an alternative graft for right hepatic artery reconstruction.
abstract: Common bile duct cancer invading right hepatic artery is sometimes diagnosed intraoperatively. Excision and safe reconstruction of the artery with suitable graft is essential. Arterial reconstruction with autologous saphenous vein graft is the preferred method practiced routinely. However the right hepatic artery reconstruction has also been carried out with several other vessels like gastroduodenal artery, right gastroepiploic artery or the splenic artery. We report a case of 63-year-old man presenting with history of progressive jaundice, pruritus and impaired appetite. Following various imaging modalities including computed tomography, endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography, intraductal ultrasound extrahepatic bile duct cancer was diagnosed; however, none of those detected vessel invasion. Intraoperatively, right hepatic artery invasion was revealed. Right hepatic artery was resected and reconstructed with a graft harvested from the first jejunal artery (JA). Postoperative outcome was satisfactory with a long-term graft patency. First JA can be a reliable graft option for right hepatic artery reconstruction.
authors: Bibek Aryal, Jun Kadono, Hiroyuki Motodaka, Tetsuya Ueno, Yutaka Imoto, Cardiovascular and Gastroenterological Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-shi, Kagoshima 890-8520, Japan.
authors: Bibek
authors: B
authors: Aryal
authors: Bibek Aryal, Jun Kadono, Hiroyuki Motodaka, Tetsuya Ueno, Yutaka Imoto, Cardiovascular and Gastroenterological Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-shi, Kagoshima 890-8520, Japan.
authors: Teruo
authors: T
authors: Komokata
authors: Bibek Aryal, Jun Kadono, Hiroyuki Motodaka, Tetsuya Ueno, Yutaka Imoto, Cardiovascular and Gastroenterological Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-shi, Kagoshima 890-8520, Japan.
authors: Jun
authors: J
authors: Kadono
authors: Bibek Aryal, Jun Kadono, Hiroyuki Motodaka, Tetsuya Ueno, Yutaka Imoto, Cardiovascular and Gastroenterological Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-shi, Kagoshima 890-8520, Japan.
authors: Hiroyuki
authors: H
authors: Motodaka
authors: Bibek Aryal, Jun Kadono, Hiroyuki Motodaka, Tetsuya Ueno, Yutaka Imoto, Cardiovascular and Gastroenterological Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-shi, Kagoshima 890-8520, Japan.
authors: Tetsuya
authors: T
authors: Ueno
authors: Bibek Aryal, Jun Kadono, Hiroyuki Motodaka, Tetsuya Ueno, Yutaka Imoto, Cardiovascular and Gastroenterological Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-shi, Kagoshima 890-8520, Japan.
authors: Akira
authors: A
authors: Furoi
authors: Bibek Aryal, Jun Kadono, Hiroyuki Motodaka, Tetsuya Ueno, Yutaka Imoto, Cardiovascular and Gastroenterological Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima-shi, Kagoshima 890-8520, Japan.
authors: Yutaka
authors: Y
authors: Imoto
keywords: Arterial graft; Arterial reconstruction; Common bile duct cancer; Jejunal artery; Right hepatic artery