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Chinese Journal of Laparoscopic Surgery(Electronic Edition) ›› 2025, Vol. 18 ›› Issue (04): 241-243. doi: 10.3877/cma.j.issn.1674-6899.2025.04.010

• Case Report • Previous Articles    

A case of laparoscopic pancreaticoduodenectomy with combined anatomical variations: Arc of Bühler and aberrant common hepatic artery

Zongying Jiang, Jiahao Chen, Min Zhai, Yijie Lu, Jianwu Wu, Xinwei Jiang()   

  1. Department of Hepatobiliary Pancreatic Surgery, the Affiliated Suzhou Hospital of Nanjing Medical University/Suzhou Municipal Hospital, Nanjing Medical University, 215000, China
  • Received:2025-05-08 Online:2025-08-30 Published:2025-11-12
  • Contact: Xinwei Jiang

Abstract:

The arc of Bühler(AOB), as a rare anatomical variation, can provide important collateral circulation for the abdominal trunk and superior mesenteric arteries, and can compensate for blood supply when the abdominal trunk/superior mesenteric arteries are occluded. This article reports a 60-year-old male patient with common bile duct adenocarcinoma. Preoperative three-dimensional reconstruction revealed an AOB with a diameter of 5.51 mm running between the common hepatic artery and the superior mesenteric artery. During the operation, this variant vessel was retained without ligation or dissection. Preoperative three-dimensional reconstruction technology can accurately identify vascular variations and optimize surgical decisions. Especially for patients who need complex surgeries such as pancreaticoduodenectomy, it can significantly reduce the risk of iatrogenic injury.

Key words: Arc of Bühler, Common hepatic artery, Variation, Laparoscope, Pancreaticoduodenectomy

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