ArticleLangenbeck's archives of surgery2026
Robotic pancreaticoduodenectomy in patients with hepatic arterial variants: surgical outcomes and technical considerations in a single-center cohort.
Article in Langenbeck's archives of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Solitary right hepatic artery passing anterior to the pancreas: a rare and challenging anatomical variant during Whipple procedure.Journal of surgical case reports · 2026Article
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Authors and funding
13 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeHepatic arterial anomalies are commonly encountered during pancreaticoduodenectomy. However, their impact on perioperative outcomes in robotic pancreaticoduodenectomy (RPD) remains unclear.
methodsWe retrospectively analyzed 79 consecutive patients who underwent RPD. Hepatic arterial anatomy was classified according to the systems of Michels and Hiatt. Perioperative outcomes were compared between patients with hepatic arterial variants and those with normal anatomy.
resultsHepatic arterial anomalies were identified in 22 patients (27.8%). According to Hiatt's classification, 57 patients (72.2%) had normal type I anatomy, while type II and III variants were observed in 4 (5.1%) and 9 (11.4%) patients, respectively. Two patients exhibited type IV variants with both replaced right and left hepatic arteries. Data are presented in the order of absence and presence of arterial anomalies. Median age was similar (72 vs. 73 years, P = 0.86), with no difference in sex distribution (P = 0.25). Operative time (549 vs. 586 min, P = 0.92), blood loss (73 vs. 50 mL, P = 0.49), rates of clinically relevant postoperative pancreatic fistula (5.3% vs. 4.5%, P = 0.69), postoperative bleeding(0% vs. 4.5%, P = 0.27), pseudoaneurysm hemorrhage (5.3% vs. 0%, P = 0.55), and major complications (Clavien-Dindo grade ≥ 3a) (8.8% vs. 9.0%, P = 0.63) did not differ significantly.
conclusionThe presence of hepatic arterial anomalies did not adversely affect perioperative outcomes in patients undergoing RPD. These findings suggest that, with appropriate preoperative planning and meticulous surgical technique, RPD can be performed safely in selected patients with hepatic arterial variants at experienced centers.
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