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Accidental Ligation of the Hepatic Artery

Accidental Ligation of the Hepatic Artery Abstract THE HE PHYSIOLOGICAL consequences attending interruption of the hepatic artery in human beings are poorly understood. Traumatic or surgical injury of the hepatic artery alone is relatively infrequent; in only a few instances have detailed postligational studies of hepatic function been performed in man. If, as often occurs, there are associated injuries or the artery has been ligated during resection of contiguous structures, the subsequent events may be difficult to interpret, even if hepatic infarcts are demonstrated at necropsy.9 This paper reports a group of 11 adults in whom the hepatic artery was accidently interrupted. The accident occurred during cholecystectomy or during pancreaticoduodenal resection in each of four instances, and once during gastrectomy, nephrectomy, and repair of an aneurysm of the hepatic artery. Two patients had associated operative injuries to the common bile duct. The proper hepatic artery was ligated in five individuals, the common hepatic artery in three, References 1. The cases were observed at the Barnes, St. Luke's, and the St. Louis City hospitals, St. Louis, and at the Malmo Hospital, Malmo, Sweden. 2. Michels, N.A.: Newer Anatomy of Liver: Variant Blood Supply and Collateral Circulation , JAMA 172:125, 1960.Crossref 3. Loeffler, L.: Factors Determining Necrosis or Survival of Liver Tissue After Ligation of Hepatic Artery , Arch Path 21:496, 1936. 4. Child, C.G., III.; Hayer, D.M.; and McClure, R.D., Jr.: Studies of the Hepatic Circulation in the Macaca Mulatta Monkey and in Man , Surg Forum 2:140, 1952. 5. From, P., and Alli, J.H.: Bacteriologic Study of Human Liver in 100 Cases , Gastroenterology 31:33, 1956. 6. Tygstrup, N., et al: Determination of the Hepatic Arterial Blood Flow and Oxygen Supply in Man by Clamping the Hepatic Artery During Surgery , J Clin Invest 41:447, 1962.Crossref 7. Restrepo, J.E., and Warren, W.D.: Total Liver Blood Flow After Portacaval Shunts, Hepatic Artery Ligation and 70 Percent Hepatectomy , Ann Surg 156:719, 1962.Crossref 8. Ternberg, J., and Butcher, H.: Blood Flow Relation Between Hepatic Artery and Portal Vein , Science 150:1030, 1965.Crossref 9. Brittain, R.S., et al: Accidental Hepatic Artery Ligation in Humans , Amer J Surg 107:822, 1964.Crossref 10. Graham, R.R., and Cannell, D.: Accidental Ligation of the Hepatic Artery , Brit J Surg 20:566, 1933.Crossref 11. Ternberg, J., and Monafo, W.: Unpublished data. 12. Andreassen, M.; Lindenburg, J.; and Winkler, K.: Peripheral Ligation of the Hepatic Artery During Surgery in Non-Cirrhotic Patients , Gut 3:167, 1962.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Accidental Ligation of the Hepatic Artery

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Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1966.01320220199031
Publisher site
See Article on Publisher Site

Abstract

Abstract THE HE PHYSIOLOGICAL consequences attending interruption of the hepatic artery in human beings are poorly understood. Traumatic or surgical injury of the hepatic artery alone is relatively infrequent; in only a few instances have detailed postligational studies of hepatic function been performed in man. If, as often occurs, there are associated injuries or the artery has been ligated during resection of contiguous structures, the subsequent events may be difficult to interpret, even if hepatic infarcts are demonstrated at necropsy.9 This paper reports a group of 11 adults in whom the hepatic artery was accidently interrupted. The accident occurred during cholecystectomy or during pancreaticoduodenal resection in each of four instances, and once during gastrectomy, nephrectomy, and repair of an aneurysm of the hepatic artery. Two patients had associated operative injuries to the common bile duct. The proper hepatic artery was ligated in five individuals, the common hepatic artery in three, References 1. The cases were observed at the Barnes, St. Luke's, and the St. Louis City hospitals, St. Louis, and at the Malmo Hospital, Malmo, Sweden. 2. Michels, N.A.: Newer Anatomy of Liver: Variant Blood Supply and Collateral Circulation , JAMA 172:125, 1960.Crossref 3. Loeffler, L.: Factors Determining Necrosis or Survival of Liver Tissue After Ligation of Hepatic Artery , Arch Path 21:496, 1936. 4. Child, C.G., III.; Hayer, D.M.; and McClure, R.D., Jr.: Studies of the Hepatic Circulation in the Macaca Mulatta Monkey and in Man , Surg Forum 2:140, 1952. 5. From, P., and Alli, J.H.: Bacteriologic Study of Human Liver in 100 Cases , Gastroenterology 31:33, 1956. 6. Tygstrup, N., et al: Determination of the Hepatic Arterial Blood Flow and Oxygen Supply in Man by Clamping the Hepatic Artery During Surgery , J Clin Invest 41:447, 1962.Crossref 7. Restrepo, J.E., and Warren, W.D.: Total Liver Blood Flow After Portacaval Shunts, Hepatic Artery Ligation and 70 Percent Hepatectomy , Ann Surg 156:719, 1962.Crossref 8. Ternberg, J., and Butcher, H.: Blood Flow Relation Between Hepatic Artery and Portal Vein , Science 150:1030, 1965.Crossref 9. Brittain, R.S., et al: Accidental Hepatic Artery Ligation in Humans , Amer J Surg 107:822, 1964.Crossref 10. Graham, R.R., and Cannell, D.: Accidental Ligation of the Hepatic Artery , Brit J Surg 20:566, 1933.Crossref 11. Ternberg, J., and Monafo, W.: Unpublished data. 12. Andreassen, M.; Lindenburg, J.; and Winkler, K.: Peripheral Ligation of the Hepatic Artery During Surgery in Non-Cirrhotic Patients , Gut 3:167, 1962.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Apr 1, 1966

References