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Trends in Hospital Volume and Failure to Rescue for Pancreatic Surgery.胰腺手术的医院手术量趋势及未能成功救治情况
J Gastrointest Surg. 2015 Sep;19(9):1581-92. doi: 10.1007/s11605-015-2800-9. Epub 2015 Mar 21.
2
A replaced right hepatic artery adjacent to pancreatic carcinoma should be divided to obtain R0 resection in pancreaticoduodenectomy.在胰十二指肠切除术中，为实现R0切除，应切断毗邻胰腺癌的替代右肝动脉。
Langenbecks Arch Surg. 2015 Jan;400(1):57-65. doi: 10.1007/s00423-014-1255-x. Epub 2014 Oct 31.
3
Pancreatic head carcinoma and right hepatic artery: embolization management-A case report.胰头癌并肝右动脉侵犯：栓塞治疗 1 例报告。
J Gastrointest Oncol. 2014 Aug;5(4):E80-3. doi: 10.3978/j.issn.2078-6891.2014.040.
4
Implications of the presence of an aberrant right hepatic artery in patients undergoing pancreaticoduodenectomy.在胰十二指肠切除术患者中存在异常右肝动脉的意义。
World J Gastrointest Surg. 2014 Jan 27;6(1):9-13. doi: 10.4240/wjgs.v6.i1.9.
5
Does an aberrant right hepatic artery really influence the short- and long-term results of a pancreaticoduodenectomy for malignant disease? A matched case-controlled study.异常右肝动脉是否真的会影响恶性疾病胰十二指肠切除术的短期和长期结果？一项匹配的病例对照研究。
J Surg Res. 2013 Dec;185(2):620-5. doi: 10.1016/j.jss.2013.07.015. Epub 2013 Jul 26.
6
Aberrant right hepatic artery in pancreaticoduodenectomy for adenocarcinoma: impact on resectability and postoperative outcomes.胰十二指肠切除术治疗腺癌时的异常右肝动脉：对可切除性和术后结果的影响。
HPB (Oxford). 2014 Mar;16(3):204-11. doi: 10.1111/hpb.12120. Epub 2013 Jun 19.
7
Preoperative embolization of replaced right hepatic artery prior to pancreaticoduodenectomy.术前栓塞右肝动脉代用品，然后行胰十二指肠切除术。
J Surg Oncol. 2012 Sep 15;106(4):509-12. doi: 10.1002/jso.23082. Epub 2012 Feb 28.
8
Evaluation of the International Study Group of Pancreatic Surgery definition of post-pancreatectomy hemorrhage in a high-volume center.在一家高容量中心评估国际胰腺外科研究组对胰腺切除术后出血的定义。
Surgery. 2012 Apr;151(4):612-20. doi: 10.1016/j.surg.2011.09.039. Epub 2011 Nov 16.
9
Influence of aberrant right hepatic artery on perioperative course and longterm survival after pancreatoduodenectomy.异常右肝动脉对胰十二指肠切除术后围手术期过程和长期生存的影响。
HPB (Oxford). 2011 Mar;13(3):161-7. doi: 10.1111/j.1477-2574.2010.00258.x. Epub 2011 Jan 27.
10
Preservation of replaced or accessory right hepatic artery during pancreaticoduodenectomy for adenocarcinoma: impact on margin status and survival.在胰十二指肠切除术治疗腺癌时保留替换或副肝右动脉：对切缘状态和生存的影响。
J Gastrointest Surg. 2010 Nov;14(11):1813-9. doi: 10.1007/s11605-010-1272-1. Epub 2010 Aug 10.

胰十二指肠切除术中右肝动脉的处理：一项系统评价

Management of the right hepatic artery in pancreaticoduodenectomy: a systematic review.

作者信息

El Amrani Mehdi, Pruvot François-René, Truant Stéphanie

机构信息

Department of Digestive Surgery and Transplantation, CHRU de Lille, Lille, France.

出版信息

J Gastrointest Oncol. 2016 Apr;7(2):298-305. doi: 10.3978/j.issn.2078-6891.2015.093.

DOI:10.3978/j.issn.2078-6891.2015.093
PMID:27034799
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4783748/
Abstract

BACKGROUND

The right hepatic artery (RHA) is the most common hepatic artery (CHA) variation. This variation may be problematic in pancreaticoduodenectomy (PD). We aimed to evaluate the impact of the RHA on postoperative and oncological outcomes.

METHODS

The PubMed database was systematically searched for comparative studies reporting management of the RHA during PD for the years 1950-2014.

RESULTS

A total of 2,278 patients were analyzed, of whom 440 (19%) had a RHA. The most CHA variation was a replaced RHA. The conservative approach was the most frequently adopted (87%) and only 8% of patients had a sacrifice without reconstruction of the RHA. Postoperative mortality and overall morbidity were similar between patients with and without RHA. Despite the preservation of the RHA in most cases, the rates of microscopic positive margin were also comparable between two groups with no impact of RHA on survival rates.

CONCLUSIONS

Postoperative and oncological outcomes seemed unaffected by the RHA in PD. Prospective studies are needed to evaluate its oncological impact.

摘要

背景

右肝动脉（RHA）是肝动脉（CHA）最常见的变异。这种变异在胰十二指肠切除术（PD）中可能会产生问题。我们旨在评估RHA对术后及肿瘤学结局的影响。

方法

系统检索PubMed数据库，查找1950年至2014年期间报告PD术中RHA处理的比较研究。

结果

共分析了2278例患者，其中440例（19%）存在RHA。最常见的CHA变异是替代RHA。最常采用的是保守方法（87%），仅有8%的患者在未重建RHA的情况下进行了牺牲。有RHA和无RHA的患者术后死亡率和总体发病率相似。尽管在大多数情况下保留了RHA，但两组的显微镜下切缘阳性率也相当，RHA对生存率无影响。

结论

PD中RHA似乎不影响术后及肿瘤学结局。需要进行前瞻性研究以评估其对肿瘤学的影响。