Open AccessFirst jejunal artery, an alternative graft for right hepatic artery reconstruction
Author(s) -
Bijay Aryal,
Teruo Komokata,
Jun Kadono,
Hiroyuki Motodaka,
Tetsuya Ueno,
Akira Furoi,
Yutaka Imoto
Publication year - 2015
Publication title -
world journal of hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.913
H-Index - 55
ISSN - 1948-5182
DOI - 10.4254/wjh.v7.i4.721
Subject(s) - medicine , gastroduodenal artery , endoscopic retrograde cholangiopancreatography , right gastroepiploic artery , magnetic resonance cholangiopancreatography , radiology , artery , common hepatic artery , bile duct , common bile duct , surgery , gastroepiploic artery , pancreatitis , bypass grafting
Common bile duct cancer invading right hepatic artery is sometimes diagnosed intraoperatively. Excision and safe reconstruction of the artery with suitable graft is essential. Arterial reconstruction with autologous saphenous vein graft is the preferred method practiced routinely. However the right hepatic artery reconstruction has also been carried out with several other vessels like gastroduodenal artery, right gastroepiploic artery or the splenic artery. We report a case of 63-year-old man presenting with history of progressive jaundice, pruritus and impaired appetite. Following various imaging modalities including computed tomography, endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography, intraductal ultrasound extrahepatic bile duct cancer was diagnosed; however, none of those detected vessel invasion. Intraoperatively, right hepatic artery invasion was revealed. Right hepatic artery was resected and reconstructed with a graft harvested from the first jejunal artery (JA). Postoperative outcome was satisfactory with a long-term graft patency. First JA can be a reliable graft option for right hepatic artery reconstruction.