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Dissection during laparoscopic pancreaticoduodenectomy (LPD) is a complex surgical intervention and requires a comprehensive understanding of anatomical relationships and vascular variations around the duodenum and hepatoduodenal ligament (HDL). While the process carries a risk of inadvertent injury to the adjacent vasculature throughout the procedure, safe dissection along the superior mesenteric artery (SMA) is extremely vital because nearly one-fifth of patients have an aberrant hepatic artery (HA) coming off of SMA (1). If exists, the replaced or accessory HA typically courses just right and inferior to the portal vein (PV). With an accompanying video, this paper aims to share the technique that we adopt to avoid injury to the aberrant HA during LPD.

Prevention of inadvertent injury to aberrant hepatic artery arising from superior mesenteric artery during laparoscopic pancreaticoduodenectomy