Sekiguchi Naoko, Takahashi Hidenori, Akita Hirofumi, Yamada Daisaku, Tomimaru Yoshito, Noda Takehiro, Mukai Yosuke, Hasegawa Shinichiro, Kobayashi Shogo, Doki Yuichiro, Eguchi Hidetoshi, Wada Hiroshi
Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka 2-2 E2, Suita-Shi, Osaka, 565-0871, Japan.
Department of Gastroenterological Surgery, Osaka International Cancer Institute, Otemae 3-1-69, Chuo-Ku, Osaka-Shi, Osaka, 541-8567, Japan.
Updates Surg. 2024 Aug;76(4):1257-1263. doi: 10.1007/s13304-024-01811-9. Epub 2024 Mar 25.
The clinical impact of replaced right hepatic artery (rRHA) resection during pancreaticoduodenectomy (PD) has not been thoroughly investigated. We therefore assessed the short- and long-term effects of rRHA resection during PD, with special reference to alterations in the volumetric profile of the liver. Patients with rRHA were divided into two groups based on the presence (R group) or absence (nR group) of resection. The nR group included cases of rRHA resection and reconstruction. We compared the postoperative short-term complications and detailed liver volume profile by CT volumetry in the long term between the R and nR groups. Forty-seven patients were eligible for the analyses of short-term outcomes (R: n = 7, nR: n = 40), and no marked difference was observed in the incidence of short-term postoperative complications. The patient cohort for the long-term investigations included 34 cases (R: n = 6, nR: n = 28), excluding patients with early recurrence. There was no significant difference in the preoperative liver volume profiles between the two groups. At 12 postoperative months, although the whole liver (WL) volume did not significantly change in either group, the ratio of the volume of the anterior/posterior sections significantly increased in the R group (R: pre- vs. 12 months, 1.01 vs. 1.28, p < 0.05; nR: pre- vs. 12 months, 1.40 vs. 1.33, p = 0.99). Long-term rRHA resection did not significantly affect the WL volume with alteration of the liver volumetric profile of each section.
胰十二指肠切除术（PD）中右肝动脉替代（rRHA）切除的临床影响尚未得到充分研究。因此，我们评估了PD期间rRHA切除的短期和长期影响，特别关注肝脏体积轮廓的变化。根据是否进行切除，将rRHA患者分为两组（R组）或未切除组（nR组）。nR组包括rRHA切除和重建的病例。我们比较了R组和nR组术后短期并发症以及通过CT容积测量法长期获得的详细肝脏体积轮廓。47例患者符合短期结果分析条件（R组：n = 7，nR组：n = 40），术后短期并发症发生率未观察到明显差异。长期研究的患者队列包括34例（R组：n = 6，nR组：n = 28），排除早期复发患者。两组术前肝脏体积轮廓无显著差异。术后12个月，尽管两组全肝（WL）体积均无显著变化，但R组前后段体积比显著增加（R组：术前vs. 12个月，1.01 vs. 1.28，p < 0.05；nR组：术前vs. 12个月，1.40 vs. 1.33，p = 0.99）。长期rRHA切除对WL体积无显著影响，但各节段肝脏体积轮廓发生改变。
