Case Report
 
A variant common hepatic artery originating from the normal celiac trunk and passing behind the portal vein successfully treated with pancreaticoduodenectomy for middle bile duct cancer: A case Report
Yoshihito Ohta1, Michiki Narushima1, Adoru Okaue1, Hisashi Nakata2, Hisahiro Matsubara3
1Department of Surgery Shimizu Kousei Hospital, Shimizu-ku, Shizuoka, Japan.
2Department Internal Medicine, Shimizu Kousei Hospital, Shimizu-ku, Shizuoka, Japan.
3Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan.

doi:10.5348/ijcri-2013-10-374-CR-3

Address correspondence to:
Yoshihito Ohta
Department of Surgery, Shimizu Kousei Hospital
578-1 Ihara-cho, Shimizu-ku, Shizuoka city
Shizuoka 424-0114
Japan
Phone: 81-54-366-3333
Fax: 81-54-366-3333
Email: yohta.work@gmail.com

Access full text article on other devices

  Access PDF of article on other devices

[HTML Full Text]   [PDF Full Text] [Print This Article]
[Similar article in Pumed] [Similar article in Google Scholar]


How to cite this article:
Ohta Y, Narushima M, Okaue A, Nakata H, Matsubara H. A variant common hepatic artery originating from the normal celiac trunk and passing behind the portal vein successfully treated with pancreaticoduodenectomy for middle bile duct cancer: A case Report. International Journal of Case Reports and Images 2013;4(10):536–540.


Abstract
Introduction: Pancreaticoduodenectomy (PD) consists of multiple complex surgical procedures, including skeletonization of the hepatic artery for lymph node dissection. Variations in the hepatic artery can be observed in 25–45% of cases, so it is important for surgeons to have knowledge of the hepatic blood supply to avoid injury that may result in biliary fistula or hepatic ischemia after surgery.
Case Report: We encountered a 67-year-old male patient with a variant common hepatic artery which originated from the normal celiac trunk and passed behind the portal vein. This patient successfully underwent a subtotal-stomach-preserving PD for middle bile duct cancer. The frequency of this variant common hepatic artery is approximately 0.1%; according to two large-scale retrospective studies on the variations of the hepatic blood supply. Unlike the different branches or number variations, it is difficult to identify the course variations with conventional visceral angiography or three-dimensional computed tomography arteriography (CTA) (3D-CT angiography image in arterial phase). The variant course of the common hepatic artery in this patient was preoperatively identified by fused images from 3D-CTA and venography.
Conclusion: Fusing images from 3D- CTA and venography should be recommended as part of the routine preoperative examination for depicting anatomical variations, such as in the variant course of the common hepatic artery in the patients planning to undergo PD.

Keywords: Variant common hepatic artery, Pancreaticoduodenectomy, Bile duct cancer


[HTML Full Text]   [PDF Full Text]

Author Contributions
Yoshihito Ohta – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content , Final approval of the version to be published
Michiki Narushima– Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Adoru Okaue – Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Hisashi Nakata – Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Hisahiro Matsubara – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© Yoshihito Ohta et al. 2012; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)