Hepatic artery anomalies and its impact in patients undergoing pancreaticoduodenectmy. A comparative study from Kashmir Valley
Background: Pancreaticoduodenectomy provides the only opportunity to cure resectable and borderline pancreatic ductal adenocarcinoma. This is linked to a high rate of morbidity and mortality, especially when combined with hepatic artery anomalies. The goal of this study was to analyse the spectrum a...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Medical Journal of Babylon |
| Subjects: | |
| Online Access: | http://www.medjbabylon.org/article.asp?issn=1812-156X;year=2022;volume=19;issue=3;spage=350;epage=353;aulast=Hassan |
| _version_ | 1797995503641690112 |
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| author | Nayeem Ul Hassan Yaqoob Hassan Prince Ajaz Ahmad Omar Javed Shah Mohamad Younis Bhat |
| author_facet | Nayeem Ul Hassan Yaqoob Hassan Prince Ajaz Ahmad Omar Javed Shah Mohamad Younis Bhat |
| author_sort | Nayeem Ul Hassan |
| collection | DOAJ |
| description | Background: Pancreaticoduodenectomy provides the only opportunity to cure resectable and borderline pancreatic ductal adenocarcinoma. This is linked to a high rate of morbidity and mortality, especially when combined with hepatic artery anomalies. The goal of this study was to analyse the spectrum and impact of hepatic artery anomalies on intraoperative and postoperative variables, and oncologic outcomes in patients undergoing pancreaticoduodenectomy. Materials and Methods: All patients with resectable periampullary or pancreatic head tumours who underwent pancreaticoduodenectmy (PD) were included. Patients were divided into two groups using computer-generated random numbers; Group A included patients who had pancreaticoduodenectmy (PD) with normal hepatic artery anatomy and Group B included patients with aberrant hepatic artery anatomy. The data was collected and analysed using SPSS 22. Results: Among the 238 patients who met the inclusion criteria, 177(74.36%) participants were included in Group A (Normal hepatic artery anatomy) and 61 (25.36%) in Group B (Aberrant hepatic artery anatomy). The mean age of patients in Group A was 51.3 ± 8.63 years while it was 50.6 ± 8.09 years in Group B. The difference in gender, BMI, pre-operative haemoglobin, bilirubin and albumin between two groups was statistically insignificant (P value >0.05). The difference in mean operative time of Group A 230.9(168–390) minutes and Group B 319.6(200–620) minutes was statistically significant (p-value <0.001). The mean blood loss in Group A (511.5 120.18 ml) was significantly lower than in Group B (623.6 127.06 ml) (P ≤ 0.001). There were no significant differences between the two groups in terms of post-operative pancreatic fistula, delayed gastric emptying, wound infection, atelectasis, hospital stay, peri-operative mortality, positive resection margins, and mean lymph node yield. Conclusion: Patients with hepatic artery anomalies who undergo pancreaticoduodenectomy have significantly more operative blood loss. This could be due to the procedure’s complexity and lengthy operative time. There were no differences between the two groups in terms of postoperative morbidity, oncological outcome, or mortality. |
| first_indexed | 2024-04-11T10:02:47Z |
| format | Article |
| id | doaj.art-5598c52ca9f444b882e11334742c9e58 |
| institution | Directory Open Access Journal |
| issn | 1812-156X 2312-6760 |
| language | English |
| last_indexed | 2024-04-11T10:02:47Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Medical Journal of Babylon |
| spelling | doaj.art-5598c52ca9f444b882e11334742c9e582022-12-22T04:30:20ZengWolters Kluwer Medknow PublicationsMedical Journal of Babylon1812-156X2312-67602022-01-0119335035310.4103/MJBL.MJBL_4_22Hepatic artery anomalies and its impact in patients undergoing pancreaticoduodenectmy. A comparative study from Kashmir ValleyNayeem Ul HassanYaqoob HassanPrince Ajaz AhmadOmar Javed ShahMohamad Younis BhatBackground: Pancreaticoduodenectomy provides the only opportunity to cure resectable and borderline pancreatic ductal adenocarcinoma. This is linked to a high rate of morbidity and mortality, especially when combined with hepatic artery anomalies. The goal of this study was to analyse the spectrum and impact of hepatic artery anomalies on intraoperative and postoperative variables, and oncologic outcomes in patients undergoing pancreaticoduodenectomy. Materials and Methods: All patients with resectable periampullary or pancreatic head tumours who underwent pancreaticoduodenectmy (PD) were included. Patients were divided into two groups using computer-generated random numbers; Group A included patients who had pancreaticoduodenectmy (PD) with normal hepatic artery anatomy and Group B included patients with aberrant hepatic artery anatomy. The data was collected and analysed using SPSS 22. Results: Among the 238 patients who met the inclusion criteria, 177(74.36%) participants were included in Group A (Normal hepatic artery anatomy) and 61 (25.36%) in Group B (Aberrant hepatic artery anatomy). The mean age of patients in Group A was 51.3 ± 8.63 years while it was 50.6 ± 8.09 years in Group B. The difference in gender, BMI, pre-operative haemoglobin, bilirubin and albumin between two groups was statistically insignificant (P value >0.05). The difference in mean operative time of Group A 230.9(168–390) minutes and Group B 319.6(200–620) minutes was statistically significant (p-value <0.001). The mean blood loss in Group A (511.5 120.18 ml) was significantly lower than in Group B (623.6 127.06 ml) (P ≤ 0.001). There were no significant differences between the two groups in terms of post-operative pancreatic fistula, delayed gastric emptying, wound infection, atelectasis, hospital stay, peri-operative mortality, positive resection margins, and mean lymph node yield. Conclusion: Patients with hepatic artery anomalies who undergo pancreaticoduodenectomy have significantly more operative blood loss. This could be due to the procedure’s complexity and lengthy operative time. There were no differences between the two groups in terms of postoperative morbidity, oncological outcome, or mortality.http://www.medjbabylon.org/article.asp?issn=1812-156X;year=2022;volume=19;issue=3;spage=350;epage=353;aulast=Hassanpancreatoduodenectomyaberrant right hepatic arterysurgical complicationpostoperative pancreatic fistulasoncological outcome |
| spellingShingle | Nayeem Ul Hassan Yaqoob Hassan Prince Ajaz Ahmad Omar Javed Shah Mohamad Younis Bhat Hepatic artery anomalies and its impact in patients undergoing pancreaticoduodenectmy. A comparative study from Kashmir Valley Medical Journal of Babylon pancreatoduodenectomy aberrant right hepatic artery surgical complication postoperative pancreatic fistulas oncological outcome |
| title | Hepatic artery anomalies and its impact in patients undergoing pancreaticoduodenectmy. A comparative study from Kashmir Valley |
| title_full | Hepatic artery anomalies and its impact in patients undergoing pancreaticoduodenectmy. A comparative study from Kashmir Valley |
| title_fullStr | Hepatic artery anomalies and its impact in patients undergoing pancreaticoduodenectmy. A comparative study from Kashmir Valley |
| title_full_unstemmed | Hepatic artery anomalies and its impact in patients undergoing pancreaticoduodenectmy. A comparative study from Kashmir Valley |
| title_short | Hepatic artery anomalies and its impact in patients undergoing pancreaticoduodenectmy. A comparative study from Kashmir Valley |
| title_sort | hepatic artery anomalies and its impact in patients undergoing pancreaticoduodenectmy a comparative study from kashmir valley |
| topic | pancreatoduodenectomy aberrant right hepatic artery surgical complication postoperative pancreatic fistulas oncological outcome |
| url | http://www.medjbabylon.org/article.asp?issn=1812-156X;year=2022;volume=19;issue=3;spage=350;epage=353;aulast=Hassan |
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