• Ulus Travma Acil Cer · Nov 2022

    Review

    Management of hepatic artery trauma during hepato-pancreato-biliary procedures: Evolving approaches, clinical outcomes, and literature review.

    • Arif Atay, Feyyaz Gungor, Yunus Sur, Orgun Gunes, Fatma Husniye Dilek, Şebnem Karasu, and Osman Nuri Dilek.
    • Department of Surgery, İzmir Katip Çelebi University Faculty of Medicine, Atatürk Training and Research Hospital, İzmir-Türkiye.
    • Ulus Travma Acil Cer. 2022 Nov 1; 28 (11): 154915571549-1557.

    BackgroundOne of the most feared complications of surgeons dealing with hepato-pancreato-biliary (HPB) surgery is hepatic artery (HA) injury. Here, we aimed to evaluate our clinical experience (laceration, transection, ligation, and resection) related to HA traumas, which have serious morbidity and mortality risks, in the light of literature data and the rapidly evolving management methods in recent years.MethodsThe files of 615 patients who were operated on for HPB pathologies in the last decade, in our hospital, were retrospectively reviewed. Clinical, laboratory, and imaging data obtained from patients' files were evaluated.ResultsA total of 13 HA traumas were detected, eight of them had HA injury and five had planned HA resection. During the post-operative follow-up period, liver abscess, anastomotic leakage, and late biliary stricture were detected.ConclusionComplications and deaths due to HA injury or ligation are less common today. The risk of complications increases in patients with hemodynamically unstable, jaundice, cholangitis, and sepsis. Revealing the variations in the pre-operative radiological evaluation and determining the appropriate approach plan will reduce the risks. In cases where HA injury is detected, arterial flow continuity should be tried to be maintained with primary anastomosis, arterial transpositions, or grafts.

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