Abstract
Two patients with an aberrant right hepatic artery (ARHA) arising from the gastroduodenal artery (GDA) underwent pancreaticoduodenectomy (PD) for cholangiocarcinoma.
Case 1. A 66-year-old man who presented to our hospital with back pain. Case 2. A 62-year-old man who presented to our hospital with jaundice. In both patients, contrast-enhanced CT showed a mass in the distal bile duct, and 3-dimensional CT demonstrated an ARHA arising from the GDA. Both patients were treated by PD with preservation of the ARHA. Histopathology revealed R0 resection in both patients. The clinical stage was T1N0M0 (stage IA) in one patient, and T2N0M0 (stage IB) in the other patient. Dumping syndrome and grade B pancreatic fistula were encountered as the postoperative complications. Absence of recurrence was confirmed at follow-up performed at 29 months in one patient and at 13 months in the other. Careful preoperative imaging is necessary prior to PD in patients with an ARHA, and some caution is needed to preserve the ARHA during the surgery.
