J Hepatobiliary Pancreat Sci. 2025 Jun 5. doi: 10.1002/jhbp.12171. Online ahead of print.
ABSTRACT
BACKGROUND: The role of the ventrally positioned right hepatic artery (RHA) in congenital biliary dilatation (CBD) remains unclear.
METHODS: We retrospectively analyzed 1464 pediatric CBD patients undergoing surgery from 2015 to 2023, comparing those with ventrally positioned versus normal RHA.
RESULTS: Ventrally positioned RHA was identified in 10.31% of patients and was associated with more frequent symptoms (e.g., abdominal pain, vomiting, jaundice), elevated liver enzymes, and a higher incidence of liver fibrosis (23.40% vs. 14.85%, p = 0.008). It was an independent risk factor for fibrosis (adjusted OR = 1.74, p = 0.011) and correlated with increased bile duct strictures and intrahepatic duct dilation. No recurrence was observed during a 41-month median follow-up.
CONCLUSIONS: Ventrally positioned RHA contributes to biliary obstruction and liver fibrosis in pediatric CBD. Early recognition and surgical correction may improve outcomes and reduce long-term complications.
PMID:40470531 | DOI:10.1002/jhbp.12171
