Journal of Gastric Cancer

  • 제16권2호
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  • Pages.72-77
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  • 2016
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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Should an Aberrant Left Hepatic Artery Arising from the Left Gastric Artery Be Preserved during Laparoscopic Gastrectomy for Early Gastric Cancer Treatment?

  • Kim, Jieun (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Su Mi (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Seo, Jeong Eun (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ha, Man Ho (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • An, Ji Yeong (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, Min Gew (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Jun Ho (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Bae, Jae Moon (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Sung (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jeong, Woo Kyoung (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Sohn, Tae Sung (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 투고 : 2016.01.25
  • 심사 : 2016.04.02
  • 발행 : 2016.06.30
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초록

Purpose: During laparoscopic gastrectomy, an aberrant left hepatic artery (ALHA) arising from the left gastric artery (LGA) is occasionally encountered. The aim of this study was to define when an ALHA should be preserved during laparoscopic gastrectomy. Materials and Methods: From August 2009 to December 2014, 1,340 patients with early gastric cancer underwent laparoscopic distal gastrectomy. One hundred fifty patients presented with an ALHA; of the ALHA was ligated in 116 patients and preserved in 34 patients. Patient characteristics, postoperative outcomes and perioperative liver function tests were reviewed retrospectively. Correlations between the diameter of the LGA measured on preoperative abdominal computed tomography and postoperative liver enzyme levels were analyzed. Results: Pearson's correlation analysis showed a positive correlation between the diameter of the LGA and serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels on postoperative day 1 in the ALHA-ligated group (P=0.039, P=0.026, respectively). Linear regression analysis estimated the diameter of the LGA to be 5.1 mm and 4.9 mm when AST and ALT levels were twice the normal limit on postoperative day 1. Conclusions: We suggest preserving the ALHA arising from a large LGA, having diameter greater than 5 mm, during laparoscopic gastrectomy to prevent immediate postoperative hepatic dysfunction.

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참고문헌

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  3. Normal and Abnormal Postoperative Imaging Findings after Gastric Oncologic and Bariatric Surgery vol.21, pp.7, 2016, https://doi.org/10.3348/kjr.2019.0822
  4. Safety of Ligation of Aberrant Left Hepatic Artery Originating from Left Gastric Artery in Laparoscopic Gastrectomy for Gastric Cancer vol.10, pp.None, 2016, https://doi.org/10.1038/s41598-020-62587-7
  5. 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 vol.21, pp.1, 2016, https://doi.org/10.5230/jgc.2021.21.e6