Roberto Cirocchi1, Vito D'Andrea2, Bruno Amato3, Claudio Renzi4, Brandon Michel Henry5, Krzysztof Andrzej Tomaszewski6, Sara Gioia7, Massimo Lancia8, Marco Artico9, Justus Randolph10. 1. Department of Surgical Sciences, University of Perugia, Piazza dell' Università 1, 06100, Perugia, Italy. Electronic address: roberto.cirocchi@unipg.it. 2. Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy. Electronic address: vito.dandrea@uniroma1.it. 3. Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy. Electronic address: bramato@unina.it. 4. Department of Surgical Sciences, University of Perugia, Piazza dell' Università 1, 06100, Perugia, Italy. Electronic address: renzicla@virgilio.it. 5. Department of Anatomy, Jagiellonian University Medical College, 12 Kopernika Street, 31-034, Krakow, Poland. Electronic address: bmhenry55@gmail.com. 6. Department of Anatomy, Jagiellonian University Medical College, 12 Kopernika Street, 31-034, Krakow, Poland. Electronic address: krzysztof.tomaszewski@uj.edu.pl. 7. Department of Surgical Sciences, University of Perugia, Piazza dell' Università 1, 06100, Perugia, Italy. Electronic address: s.gioia@aospterni.it. 8. Department of Surgical Sciences, University of Perugia, Piazza dell' Università 1, 06100, Perugia, Italy. Electronic address: massimo.lancia@unipg.it. 9. Department "Organi di Senso", Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy. Electronic address: marco.artico@uniroma1.it. 10. Georgia Baptist College of Nursing, Mercer University, 3001 Mercer University Drive, 30341, Atlanta, GA, USA. Electronic address: randolph_jj@mercer.edu.
Abstract
BACKGROUND: The Aberrant Left Hepatic Artery (ALHA) is replaced when it does not originate from the hepatic artery proper and it is the only supply to that part of the liver, while an accessory artery coexists with a normal artery. The aim of this systematic review is to evaluate the incidence of ALHAs including the one arising from the Left Gastric Artery, also named Hyrtl's artery. METHODS: A literature search in PubMed, SCOPUS, WOS and Google Scholar was performed. The risk of bias was assessed by means of the AQUA tool. The main outcome was the prevalence of ALHA. Secondary outcomes were the prevalence of the accessory and replaced left hepatic arteries. A subgroup analysis was conducted by geographic region and type of evaluation. RESULTS: This review included 57 studies, with a total of 19,284 patients. The majority of the studies involved the use of radiological techniques -especially Angio-CT-and were performed in Asia. The overall risk of bias was moderate. The overall prevalence of the ALHA was 13.52%; the overall prevalence was 8.26% for the Replaced ALHA and 5.55% for the Accessory ALHA. In the 18 studies that employed Michels' classification, Type II had the lowest prevalence (0.36%) and Type VII the highest prevalence (6.62%). DISCUSSION: Some of the studies included did not distinguish between the ''replaced'' and ''accessory'' ALHA (34.25%). Some surgical dissection techniques proved insufficient for the localization of other hepatic arteries. These results suggest that an accurate preoperative radiological evaluation is needed to localize replaced arteries.
BACKGROUND: The Aberrant Left Hepatic Artery (ALHA) is replaced when it does not originate from the hepatic artery proper and it is the only supply to that part of the liver, while an accessory artery coexists with a normal artery. The aim of this systematic review is to evaluate the incidence of ALHAs including the one arising from the Left Gastric Artery, also named Hyrtl's artery. METHODS: A literature search in PubMed, SCOPUS, WOS and Google Scholar was performed. The risk of bias was assessed by means of the AQUA tool. The main outcome was the prevalence of ALHA. Secondary outcomes were the prevalence of the accessory and replaced left hepatic arteries. A subgroup analysis was conducted by geographic region and type of evaluation. RESULTS: This review included 57 studies, with a total of 19,284 patients. The majority of the studies involved the use of radiological techniques -especially Angio-CT-and were performed in Asia. The overall risk of bias was moderate. The overall prevalence of the ALHA was 13.52%; the overall prevalence was 8.26% for the Replaced ALHA and 5.55% for the Accessory ALHA. In the 18 studies that employed Michels' classification, Type II had the lowest prevalence (0.36%) and Type VII the highest prevalence (6.62%). DISCUSSION: Some of the studies included did not distinguish between the ''replaced'' and ''accessory'' ALHA (34.25%). Some surgical dissection techniques proved insufficient for the localization of other hepatic arteries. These results suggest that an accurate preoperative radiological evaluation is needed to localize replaced arteries.
Authors: Tae Won Choi; Jin Wook Chung; Hyo-Cheol Kim; Myungsu Lee; Jin Woo Choi; Hwan Jun Jae; Saebeom Hur Journal: Radiol Cardiothorac Imaging Date: 2021-08-19
Authors: Malgorzata Emilia Legocka; Sadegh Toutounchi; Ryszard Pogorzelski; Ewa Krajewska; Krzysztof Celejewski; Zbigniew Galazka Journal: Open Med (Wars) Date: 2020-02-20
Authors: Bruno Amato; Renato Patrone; Gennaro Quarto; Rita Compagna; Roberto Cirocchi; Georgi Popivanov; Vincenza Granata; Andrea Belli; Francesco Izzo Journal: Open Med (Wars) Date: 2020-09-11