title: Resection-Reconstruction of Aberrant Right Hepatic Artery During Whipple Procedure (Pancreaticoduodenectomy).
abstract: Aberrant hepatic arterial anatomy poses a challenge for the surgeon during Whipple procedure. Intraoperative injury to the aberrant vasculature results in hemorrhagic or ischemic complications involving the liver and biliary tree. We report a case of replaced right hepatic artery arising from the superior mesenteric artery in a patient with periampullary carcinoma of the pancreas, undergoing pancreaticoduodenectomy. The aberrant artery was found to be coursing through the pancreatic parenchyma. This is a rare vascular anomaly. Resection of the arterial segment and end-to-end anastomosis was fashioned. Intrapancreatic course of the replaced right hepatic artery is a rare anomaly and is best managed by preoperative identification on radiology and meticulous intra-operative dissection and preservation. However, for an intrapancreatic course, resection and reconstruction may occasionally be required.
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital, Lahore.
authors.forename: Raza
authors.initials: R
authors.lastname: Sayyed
authors.affiliation: Department of Surgical Radiology, Shaukat Khanum Memorial Cancer Hospital, Lahore.
authors.forename: Iffat
authors.initials: I
authors.lastname: Rehman
authors.affiliation: Department of Surgical Radiology, Shaukat Khanum Memorial Cancer Hospital, Lahore.
authors.forename: Imran Khalid
authors.initials: IK
authors.lastname: Niazi
authors.affiliation: Department of Surgical GI Medicine, Shaukat Khanum Memorial Cancer Hospital, Lahore.
authors.forename: Muhammed Aasim
authors.initials: MA
authors.lastname: Yusuf
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital, Lahore.
authors.forename: Aamir Ali
authors.initials: AA
authors.lastname: Syed
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital, Lahore.
authors.forename: Faisal
authors.initials: F
authors.lastname: V
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D005260:Female; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D016896:Treatment Outcome