Article ; Online: The Presence of an Aberrant Right Hepatic Artery Did Not Influence Surgical and Oncological Outcomes After Pancreaticoduodenectomy: A Comprehensive Systematic Review and Meta-Analysis.
2023 Volume 47, Issue 12, Page(s) 3308–3318
Abstract: Background: The presence of an aberrant right hepatic artery (a-RHA) could influence the oncological and postoperative results after pancreaticoduodenectomy (PD).: Methods: A systematic review and metanalysis were conducted, including all comparative ...
| Abstract | Background: The presence of an aberrant right hepatic artery (a-RHA) could influence the oncological and postoperative results after pancreaticoduodenectomy (PD). Methods: A systematic review and metanalysis were conducted, including all comparative studies having patients who underwent PD without (na-RHA) or with a-RHA. The results were reported as risk ratios (RRs), mean differences (MDs), or hazard ratios (HRs) with 95% confidence intervals (95 CI). The random effects model was used to calculate the effect sizes. The endpoints were distinguished as critical and important. Critical endpoints were: R1 resection, overall survival (OS), morbidity, mortality, and biliary fistula (BL). Important endpoints were: postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), post pancreatectomy hemorrhage (PPH), length of stay (LOS), and operative time (OT). Results: Considering the R1 rate no significant differences were observed between the two groups (RR 1.06; 0.89 to 1.27). The two groups have a similar OS (HR 0.95; 0.85 to 1.06). Postoperative morbidity and mortality were similar between the two groups, with a RR of 0.97 (0.88 to 1.06) and 0.81 (0.54 to 1.20), respectively. The biliary fistula rate was similar between the two groups (RR of 1.09; 0.72 to 1.66). No differences were observed for non-critical endpoints. Conclusion: The presence of a-RHA does not affect negatively the short-term and long-term clinical outcomes of PD. |
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| MeSH term(s) | Humans ; Pancreaticoduodenectomy/adverse effects ; Pancreaticoduodenectomy/methods ; Pancreatectomy/methods ; Biliary Fistula ; Hepatic Artery/surgery ; Pancreas/surgery ; Pancreatic Fistula/etiology ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery |
| Language | English |
| Publishing date | 2023-10-10 |
| Publishing country | United States |
| Document type | Meta-Analysis ; Systematic Review ; Journal Article ; Review |
| ZDB-ID | 224043-9 |
| ISSN | 1432-2323 ; 0364-2313 |
| ISSN (online) | 1432-2323 |
| ISSN | 0364-2313 |
| DOI | 10.1007/s00268-023-07191-2 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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