Operative injury to the hepatic artery. Consequences of a biliary-enteric anastomosis and principles for rational management
P. E. Majno, R. Pretre, G. Mentha and P. Morel
Department of Surgery, Cantonal University Hospital, Geneva, Switzerland.
Although the interruption of the hepatic arterial flow usually is well
tolerated, this is not always the case, and it is important to predict in
which circumstances complications are likely to occur. The main
determinants that should guide the surgeon confronted with this problem are
(1) whether the portal circulation is normal, (2) whether structures
carrying collateral blood supply have been interrupted, and (3) whether
some form of biliary reconstruction is needed. We present our experience
with three patients in whom the hepatic artery was damaged at operation as
examples of how this injury can be dealt with in practice and discuss the
measures to prevent or treat the complications that developed.
