World Journal of Surgery

, Volume 31, Issue 12, pp 2384–2391 | Cite as

Assessment of Hepatic Arterial Anatomy in Keeping with Preservation of the Vasculature While Performing Pancreatoduodenectomy: An Opinion

  • Sung Hoon YangEmail author
  • Yong Hu Yin
  • Jin-Young Jang
  • Seung Eun Lee
  • Jin Wook Chung
  • Kyung-Suk Suh
  • Kuhn Uk Lee
  • Sun-Whe Kim



Pancreatic surgeons often must make decisions regarding hepatic artery (HA) resection while performing a pancreatoduodenectomy (PD). The purpose of this report was to review and summarize HA resection experience with a focus on vascular preservation during PD and to develop a useful guideline for pancreatic surgeons in dealing with these needs.


We reviewed 1324 cases that had available computed tomographic and angiographic findings and summarized the problematic HA variations encountered in PD. In reviewing our PD series (n = 254), we have created a set of guidelines that enable a pragmatic approach to the unique variations in HA and the risks of cancer invasion.


Challenging HA variations during PD were found in 20.1% of the cases and included the common HA arising from the superior mesenteric artery (SMA) (2.34%), a replaced right HA (RHA) from the SMA (9.82%), an RHA or left HA from the gastroduodenal artery (0.97%), and the right anterior or right posterior HA from the SMA (1.06%), among others. In our PD series, the problematic HAs (15.8%) were preserved, except for a single case (0.4%) in which PD involved en bloc resection of the RHA from the SMA due to a cancerous invasion and without right hemihepatectomy.


Surgeons should have knowledge of the anatomically variable vasculature of the HA when planning for PD. Preoperative imaging studies can aid and should be performed in anticipation of the potential HA variations during PD.


Hepatic Artery Superior Mesenteric Artery Bloc Resection Superior Mesenteric Vein Common Hepatic Artery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This study was supported by a grant (no. 0520320) from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea.


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Copyright information

© Société Internationale de Chirurgie 2007

Authors and Affiliations

  • Sung Hoon Yang
    • 1
    Email author
  • Yong Hu Yin
    • 2
  • Jin-Young Jang
    • 1
  • Seung Eun Lee
    • 1
  • Jin Wook Chung
    • 2
  • Kyung-Suk Suh
    • 1
  • Kuhn Uk Lee
    • 1
  • Sun-Whe Kim
    • 1
  1. 1.Department of SurgerySeoul National University College of Medicine, Seoul National University HospitalSeoulKorea
  2. 2.Department of RadiologySeoul National University College of MedicineSeoulKorea

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