Abstract
Hepatic arterial and portal venous anomalies in living liver donors are not uncommon. Modified surgical techniques may be required in such circumstances, although the safety of the living donor must always be given top priority. We describe here a successful portal venous reconstruction in a living donor with an anomalous hepatic arterial and portal venous anatomy in which the right anterior and posterior hepatic arteries encircled the main portal vein. Although such an anomaly of hepatic vessels was not frequently encountered, we should be able to alter the surgical strategy to deal with it. This case illustrates the importance of preoperative hepatic artery and portal venous evaluation in all living donors to identify the feasibility of modifying vessel anastomoses in living donors, as well as recipients, before living donor liver transplantation.
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Umeshita K, Fujiwara K, Kiyosawa K, et al. Operative morbidity of living liver donors in Japan. Lancet 2003;362:687–690.
Urata K, Kawasaki S, Matsunami H, et al. Calculation of child and adult standard liver volume for liver transplantation. Hepatology 1995;21:1317–1321.
Gruttadauria S, Foglieni CS, Doria C, Luca A, Lauro A, Marino IR. The hepatic artery in liver transplantation and surgery: Vascular anomalies in 701 cases. Clin Transplant 2001; 15:359–363.
Sugawara Y, Kaneko J, Akamatsu N, Makuuchi M. Arterial anatomy unsuitable for a right liver donation. Liver Transpl 2003;9:1116–1117.
Marcos A, Killackey M, Orloff MS, Mieles L, Bozorgzadeh A, Tan HP. Hepatic arterial reconstruction in 95 adult right lobe living donor liver transplants: Evolution of anastomotic technique. Liver Transpl 2003;9:570–574.
Soliman T, Bodingbauer M, Langer F, et al. The role of complex hepatic artery reconstruction in orthotopic liver transplantation. Liver Transpl 2003;9:970–975.
Cheng YF, Huang TL, Lee TY, Chen TY, Chen CL. Variation of the intrahepatic portal vein: Angiographic demonstration and application in living-related hepatic transplantation. Transplant Proc 1996;28:1667–1668.
Lee SG, Hwang S, Kim KH, et al. Approach to anatomic variations of the graft portal vein in right lobe living-donor liver transplantation. Transplantation 2003;75:S28-S32.
Ebata T, Nagino M, Kamiya J, Uesaka K, Nagasaka T, Nimura Y. Hepatectomy with portal vein resection for hilar cholangiocarcinoma: Audit of 52 consecutive cases. Ann Surg 2003;238:720–727.
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Marubashi, S., Dono, K., Sakon, M. et al. Portal venous reconstruction in a living liver donor with an anomalous hepatic arterial and portal venous anatomy. J Gastrointest Surg 9, 365–368 (2005). https://doi.org/10.1016/j.gassur.2004.05.019
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DOI: https://doi.org/10.1016/j.gassur.2004.05.019