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간ㆍ담도ㆍ췌장 수술에서 간동맥의 안전한 처리지침 수립을 위한 연구 −간동맥의 해부학적 변이를 중심으로−
Establishment of a Guideline for the Safe Management of Anatomical Hepatic Artery Variations While Performing Major Hepato-pancreatico-biliary Surgery

Cited 2 time in Web of Science Cited 0 time in Scopus
Authors
양성훈; 인용후; 장진영; 이승은; 정진욱; 서경석; 이건욱; 김선회
Issue Date
2009-02
Publisher
KOREAN SURGICAL SOCIETY
Citation
JOURNAL OF THE KOREAN SURGICAL SOCIETY; Vol.76; no.2; 100-108
Keywords
Hepatic arteryAnatomical variationsHepato-pancreatico-biliary surgery간동맥해부학적 변이간담췌 수술
Abstract
Purpose: Hepato-pancreatico-biliary (HPB) surgeons often must make decisions regarding hepatic artery (HA) resection while performing major HPB surgery. The purpose of this report was to review and summarize HA resection experience with a focus on vascular preservation during major HPB surgery and to develop a useful algorithm in dealing with these needs. Methods: We reviewed 1,324 cases that had available computed tomographic and angiographic findings and summarized the problematic HA variations encountered in major HPB surgery. In reviewing our series and previous studies, we have created a set of guidelines that enables a pragmatic approach to the unique variations in HA and the risks of cancer invasion. Results: Challenging HA variations during major HPB surgery were found in 25.7% of the cases and included variations of common HA from superior mesenteric artery (SMA), gastroduodenal artery (GDA), aorta, celiaco-mesenteric (CM) trunk or left gastric artery (LGA) (3.70%), the variations of the right HA from SMA, GDA, aorta, celiac axis (CA) including CM trunk or LGA (12.76%), the variations of the left HA from LGA, CA or GDA (4.46%), and the mixed types of the aberrant left medial HA and/or left lateral HA and/or right anterior HA and/or right posterior HA (2.11%). Conclusion: Surgeons Should have knowledge of the anatomically variable vasculature of the HA when planning for major HPB surgery. Preoperative imaging studies can aid and should be performed in anticipation of potential HA variations during major HPB surgery.
ISSN
2233-7903
Language
Korean
URI
http://hdl.handle.net/10371/77860
DOI
https://doi.org/10.4174/jkss.2009.76.2.100
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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