TY  - JOUR
T1  - Aberrant left hepatic artery arising from the left gastric artery: perioperative effects of a risky vascular anomaly in gastrectomy
TT  - Sol gastrik arterden çıkan aberran sol hepatik arter varlığı: gastrektomide riskli damar anomalisinin perioperatif etkileri
AU  - Kılavuz, Hüseyin
AU  - Düzköylü, Yiğit
AU  - Şevik, Hüsnü Ozan
AU  - Tekin, Oğuzhan
AU  - Yardımcı, Aytül Hande
AU  - Yüksel, Sercan
PY  - 2025
DA  - October
Y2  - 2025
DO  - 10.32322/jhsm.1771103
JF  - Journal of Health Sciences and Medicine
JO  - J Health Sci Med /JHSM /jhsm
PB  - MediHealth Academy Yayıncılık
WT  - DergiPark
SN  - 2636-8579
SP  - 981
EP  - 987
VL  - 8
IS  - 6
LA  - en
AB  - Aims: The aim of this study was to analyze the results of the choice of cutting and preservation in different surgical methods in the presence of aberrant left hepatic artery (ALHA) during gastric cancer surgery.Methods: This study was conducted as a single-center, retrospective study between 01/01/2022 and 31/08/2023. Patients who underwent open, laparoscopic and robotic surgery due to gastric cancer were included. The presence of ALHA in preoperative computed tomography scans was screened using the application focusing on vascular anatomy in the radiology automation system. The results of patients with and without ALHA were analyzed.Results: No statistically significant difference was observed between the groups in terms of duration of surgery, length of hospital stay, history of neoadjuvant therapy, total number of lymph nodes removed, and number of metastatic lymph nodes.Conclusion: We recommend close postoperative monitoring of liver enzymes and collaboration with an experienced radiologist in patients with suspected ALHA
KW  - Aberrant left hepatic artery
KW  - gastric cancer
KW  - oncological surgery
KW  - robotic surgery
N2  - Amaç: Bu çalışmanın amacı, mide kanseri cerrahisi sırasında aberran sol hepatik arter (ASHA) varlığında farklı cerrahi yöntemlerde ASHA’ya yönelik  yaklaşımların sonuçlarını analiz etmektir.Yöntemler: Bu çalışma, 01.01.2022 ile 31.08.2023 tarihleri arasında tek merkezli, retrospektif bir çalışma olarak yürütülmüştür. Mide kanseri nedeniyle açık, laparoskopik ve robotik cerrahi geçiren hastalar çalışmaya dahil edilmiştir. Ameliyat öncesi bilgisayarlı tomografi taramalarında AsHA varlığı, radyoloji otomasyon sistemindeki vasküler anatomiye odaklanan uygulama kullanılarak taranmıştır. ASHA olan ve olmayan hastaların sonuçları analiz edilmiştir.Bulgular: Gruplar arasında ameliyat süresi, hastanede kalış süresi, neoadjuvan tedavi öyküsü, çıkarılan toplam lenf nodu sayısı ve metastatik lenf nodu sayısı açısından istatistiksel olarak anlamlı bir fark gözlenmemiştir.Sonuçlar: ASHA şüphesi olan hastalarda ameliyat sonrası karaciğer enzimlerinin yakın takibini ve deneyimli bir radyologla işbirliği yapılmasını öneriyoruz.
CR  - Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. doi:10.3322/caac.21492
CR  - Rawla P, Barsouk A. Epidemiology of gastric cancer: global trends, risk factors and prevention. Prz Gastroenterol. 2019;14(1):26-38. doi:10.5114/pg.2018.80001
CR  - Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2018 (5th edition). Gastric Cancer. 2021;24(1):1-21. doi:10.1007/s10120-020-01042-y
CR  - Sun YQ, Zhong Q, Lv CB, et al. The safety and efficacy of neoadjuvant immunochemotherapy following laparoscopic gastrectomy for gastric cancer: a multicentre real-world clinical study. Int J Surg. 2024;110(8): 4830-4838. doi:10.1097/JS9.0000000000001468
CR  - Choi TW, Chung JW, Kim HC, et al. Anatomic variations of the hepatic artery in 5625 patients. Radiol Cardiothorac Imaging. 2021;3(4):e210007. doi:10.1148/ryct.2021210007
CR  - Sheta AA. Prevalence of anatomical variants in the branches of celiac and superior mesenteric arteries among Egyptians. Anat Cell Biol. 2024; 57(3):353-362. doi:10.5115/acb.23.316
CR  - Cirocchi R, D’Andrea V, Amato B, et al. Aberrant left hepatic arteries arising from left gastric arteries and their clinical importance. Surgeon. 2020;18(2):100-112. doi:10.1016/j.surge.2019.06.002
CR  - Ang RRG, Lee HJ, Bae JS, et al. Safety of ligation of aberrant left hepatic artery originating from left gastric artery in laparoscopic gastrectomy for gastric cancer. Sci Rep. 2020;10(1):5856. doi:10.1038/s41598-020-62587-7
CR  - Kim J, Kim SM, Seo JE, et al. Should an aberrant left hepatic artery arising from the left gastric artery be preserved during laparoscopic gastrectomy for early gastric cancer treatment? J Gastric Cancer. 2016; 16(2):72-77. doi:10.5230/jgc.2016.16.2.72
CR  - Shinohara T, Ohyama S, Muto T, Yanaga K, Yamaguchi T. The significance of the aberrant left hepatic artery arising from the left gastric artery at curative gastrectomy for gastric cancer. Eur J Surg Oncol. 2007;33(8):967-971. doi:10.1016/j.ejso.2007.02.030
CR  - Huang CM, Chen QY, Lin JX, et al. Short-term clinical implications of the accessory left hepatic artery in patients undergoing radical gastrectomy for gastric cancer. PLoS One. 2013;8(5):e64300. doi:10.1371/journal.pone.0064300
CR  - Oki E, Sakaguchi Y, Hiroshige S, Kusumoto T, Kakeji Y, Maehara Y. Preservation of an aberrant hepatic artery arising from the left gastric artery during laparoscopic gastrectomy for gastric cancer. J Am Coll Surg. 2011;212(5):e25-e27. doi:10.1016/j.jamcollsurg.2011.01.009
CR  - Tao W, Peng D, Cheng YX, Zhang W. Clinical significance of aberrant left hepatic artery during gastrectomy: a systematic review. World J Clin Cases. 2022;10(10):3121-3130. doi:10.12998/wjcc.v10.i10.3121
CR  - Lee S, Son T, Song JH, et al. Adverse effects of ligation of an aberrant left hepatic artery arising from the left gastric artery during radical gastrectomy for gastric cancer: a propensity score matching analysis. J Gastric Cancer. 2021;21(1):74-83. doi:10.5230/jgc.2021.21.e6
CR  - Liu P, Wei M, Sun D, et al. Study on the application of preoperative three-dimensional CT angiography of perigastric arteries in laparoscopic radical gastrectomy. Sci Rep. 2022;12(1):6026. doi:10.1038/s41598-022-09584-0
CR  - Sano A, Saito K, Kuriyama K, et al. Risk factors for postoperative liver enzyme elevation after laparoscopic gastrectomy for gastric cancer. In Vivo. 2021;35(2):1227-1234. doi:10.21873/invivo.12373
CR  - Jeong GA, Cho GS, Shin EJ, Lee MS, Kim HC, Song OP. Liver function alterations after laparoscopy-assisted gastrectomy for gastric cancer and its clinical significance. World J Gastroenterol. 2011;17(3):372-378. doi:10.3748/wjg.v17.i3.372
CR  - Ozutemiz C, Obuz F, Taylan A, Atila K, Bora S, Ellidokuz H. Volume change of segments II and III of the liver after gastrectomy in patients with gastric cancer. Diagn Interv Radiol. 2016;22(2):109-115. doi:10.5152/dir.2016.15143
UR  - https://doi.org/10.32322/jhsm.1771103
L1  - https://dergipark.org.tr/en/download/article-file/5181628
ER  -