Article Commentary: Aberrant Hepatic Arterial Anatomy and the Whipple Procedure: Lessons Learned

Author:

Chamberlain Ronald S.1,El-Sedfy Abraham2,Rajkumar Dhiraj3

Affiliation:

1. Department of Surgery, St. Barnabas Medical Center, Livingston, New Jersey; the Department of Surgery, University of Medicine & Dentistry of New Jersey, Newark, New Jersey; and St. George's University, School of Medicine, Grenada, West Indies

2. Departments of Surgery, St. Barnabas Medical Center, Livingston, New Jersey

3. Departments of Radiology, St. Barnabas Medical Center, Livingston, New Jersey

Abstract

Appreciation and study of hepatic arterial anatomical variability is essential to the performance of a pancreaticoduodenectomy to avoid surgical complications such as bleeding, hepatic ischemia/failure, and anastomotic leak/stricture. Awareness of this variability permits the surgeon to adapt the surgical technique to deal with anomalies identified preoperatively or intraoperatively thereby preventing unnecessary surgical morbidity and mortality. The objective of our study is to provide a comprehensive review of the anatomic arterial anomalies and discuss surgical strategies that will equip the surgeon to deal with all anomalies that may be encountered a priori or en passant during the course of a Whipple procedure.

Publisher

SAGE Publications

Subject

General Medicine

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