Aberrant left hepatic artery in laparoscopic antireflux procedures View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2004-04-02

AUTHORS

P. J. Klingler, M. H. Seelig, N. R. Floch, S. A. Branton, M. C. Freund, N. Katada, R. A. Hinder

ABSTRACT

BackgroundThe aberrant left hepatic artery (ALHA) is an anatomic variation that may present an obstacle in laparoscopic antireflux procedures. Based on our experience, we addressed the following questions: How frequent is ALHA? When or why is it divided? What is the outcome in patients after division of the ALHA?MethodsFrom a prospective collected database of 720 patients undergoing laparoscopic antireflux surgery, we collected the following information: presence of an ALHA, clinical data, diagnostic workup, operative reports, laboratory data, and follow-up data.ResultsIn 57 patients (7.9%) (37 men and 20 women; mean age, 51 ± 15.7 years), an ALHA was reported. Hiatal dissection was impaired in 17 patients (29.8%), requiring division of the ALHA. In three patients (5.3%), the artery was injured during dissection; in one case (1.8%), it was divided because of ongoing bleeding. Ten of the divided ALHA (55.5%) were either of intermediate size or large. Mean operating time was 2.2 ± 0.8 h; mean blood loss was 63 ± 49 ml. Postoperative morbidity was 5.3% and mortality was 0%. None of the patients with divided hepatic arteries had postoperative symptoms related to impaired liver function. Postoperatively, two patients (11.7%) had transient elevated liver enzymes. At a mean follow-up of 28.5 ± 12.8 months, no specific complaints could be identified.ConclusionsALHA is not an uncommon finding in laparoscopic antireflux surgery and may be found in ≥8% of patients. Division may be required due to impaired view of the operating field or bleeding. Patients do not experience clinical complaints after division, but liver enzymes may be temporarily elevated. More... »

PAGES

807-811

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URI

http://scigraph.springernature.com/pub.10.1007/s00464-003-8280-0

DOI

http://dx.doi.org/10.1007/s00464-003-8280-0

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https://app.dimensions.ai/details/publication/pub.1045223204

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/15054654


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