Management of Aberrant Left Hepatic Artery during Laparoscopic Gastrectomy and Consequences


Hakseven M., cetindag O., Avsar G., DERYOL R., Dokcu S., Culcu S., ...Daha Fazla

Journal of Laparoendoscopic and Advanced Surgical Techniques, cilt.32, sa.9, ss.999-1004, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 32 Sayı: 9
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1089/lap.2022.0005
  • Dergi Adı: Journal of Laparoendoscopic and Advanced Surgical Techniques
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.999-1004
  • Anahtar Kelimeler: laparoscopic gastrectomy, aberrant left hepatic artery, gastric cancer, lymph node dissection, liver enzymes, LEFT GASTRIC ARTERY, RADICAL GASTRECTOMY, CANCER, LIVER
  • Ankara Üniversitesi Adresli: Evet

Özet

© 2022, Mary Ann Liebert, Inc., publishers 2022.Introduction: Aberrant left hepatic artery (ALHA) can exist in up to 25% of the population. The presence of ALHA during lymph node (LN) dissection in gastric cancer may complicate the process. In this study, we aimed to evaluate the existence rate, management, and consequences of ALHA in our laparoscopic gastrectomy series. Patients and Methods: Demographical and clinical data of laparoscopically operated 158 consecutive gastric cancer patients were collected retrospectively. Study patients were divided into three groups according to absence, existence and preservation, and existence and sacrification of ALHA. Harvested LN numbers, operation time, and postoperative alanine aminotransferase (ALT), aspartate aminotransferase (AST), and lactate dehydrogenase values on consecutive days were analyzed using Kruskal-Wallis and Mann-Whitney U tests. P < .05 is accepted as significant. Results: The median AST and ALT values of the ALHA-sacrificed group were higher than those of the group without ALHA and the ALHA-preserved group on the 1st, 3rd, and 5th postoperative days (P < .05). On the 10th day, liver enzymes returned to normal values. Conclusion: Adequate and appropriate dissection of LNs while preserving ALHA can be performed without prolonging the operation time. Sacrification of ALHA causes an increase in liver enzymes, with spontaneous recovery in most cases.