Variant Right Hepatic Arteries Encountered in Pancreatoduodenectomy: Morphological Aspects and Management

The aim of this study was to investigate anatomical features and management of aberrant right hepatic arteries in a cohort of patients who underwent pancreatoduodenectomy. Medical records of all patients who underwent proximal pancreatoduodenectomy at the University Hospital Kralovske Vinohrady between November 2012 and December 2022 were reviewed. The hepatic arteries were reviewed on preoperative computed tomograms. Demographic, surgical, histopathological, and postoperative details were compared between patients with normal and aberrant right hepatic arteries. In total 331 patients were included. Aberrant right hepatic arteries were found in 57 patients. There were no statically significant differences in surgical and histopathological features or outcomes between patients with normal and aberrant hepatic arteries. The artery was preserved in 50 cases, sacrificed in two cases, injured and repaired in one case, and resected and reconstructed in four cases. In most cases aberrant hepatic vessels can be preserved. Hepatic arteries should be studied preoperatively on computed tomography and the surgical strategy should be chosen accordingly. Variant right hepatic artery was not associated with prolonged length of surgery or increased mortality or morbidity.