Service de Chirurgie Hépatobiliaire et Digestive, Hôpital Pontchaillou, Centre Hospitalier Universitaire, Université de Rennes 1, Rennes, France; Inserm, UMR991, Foie, Métabolismes et Cancer, Université de Rennes 1, Rennes, France.
J Surg Res. 2013 Dec;185(2):620-5. doi: 10.1016/j.jss.2013.07.015. Epub 2013 Jul 26.
An aberrant right hepatic artery (ARHA) is a common anatomic variation. The risk associated with ARHA during pancreaticoduodenectomy (PD) continues to be debated. The aim of this study was to compare the clinical outcomes and survival after PD with ARHA against a matched cohort of patients without ARHA.
PD with an ARHA performed between January 2000 and September 2009 were retrospectively analyzed. Patients with an ARHA (group 1) were matched (1:2) to patients without an ARHA (group 2) according to gender, age, body mass index, type of tumor, and lymph node status. Peri- and postoperative outcomes were compared between the two groups. Overall survival and disease-free survival were estimated by Kaplan-Meier method and compared with log-rank test.
A total of 29 patients (group 1) and 55 patients (group 2) were compared. In group 1, an ARHA entered the tumor in six cases (20.7%), was sacrificed in four cases, and repaired in two cases. There was no difference regarding the rate of intraoperative and postoperative variables between the two groups. The oncological clearance (P = 0.731) and survival (overall survival, P = 0.843; disease-free survival, P = 0.832) were also similar.
Our study showed that the presence of an ARHA during PD was not associated with worse postoperative outcomes or survival.
异常右肝动脉（ARHA）是一种常见的解剖变异。在胰十二指肠切除术（PD）中，ARHA 相关风险仍存在争议。本研究旨在比较伴有 ARHA 的 PD 与无 ARHA 的匹配患者的临床结局和生存情况。
回顾性分析 2000 年 1 月至 2009 年 9 月期间行 PD 且伴有 ARHA 的患者。根据性别、年龄、体重指数、肿瘤类型和淋巴结状态，将伴有 ARHA 的患者（组 1）与无 ARHA 的患者（组 2）进行 1:2 匹配。比较两组患者的围手术期结局。采用 Kaplan-Meier 法估计总生存期和无病生存期，并采用对数秩检验进行比较。
共比较了 29 例（组 1）和 55 例（组 2）患者。在组 1 中，有 6 例（20.7%）ARHA 进入肿瘤，4 例 ARHA 被牺牲，2 例 ARHA 被修复。两组患者术中及术后变量的发生率无差异。两组患者的肿瘤清除率（P=0.731）和生存情况（总生存期，P=0.843；无病生存期，P=0.832）也相似。
本研究表明，PD 中伴有 ARHA 并不会导致术后结局或生存恶化。
