First jejunal artery, an alternative graft for right hepaticartery reconstruction

Common bile duct cancer invading right hepatic artery is sometimes diagnosed intraoperatively. Excision and safe reconstruction of the artery with suitable graftis essential. Arterial reconstruction with autologoussaphenous vein graft is the preferred method practicedroutinely. However the right hepatic artery reconstructionhas also been carried out with several other vesselslike gastroduodenal artery, right gastroepiploic arteryor the splenic artery. We report a case of 63-year-oldman presenting with history of progressive jaundice,pruritus and impaired appetite. Following variousimaging modalities including computed tomography,endoscopic retrograde cholangiopancreatography,magnetic resonance cholangiopancreatography, intraductalultrasound extrahepatic bile duct cancer wasdiagnosed; however, none of those detected vesselinvasion. Intraoperatively, right hepatic artery invasionwas revealed. Right hepatic artery was resectedand reconstructed with a graft harvested from thefirst jejunal artery （JA）. Postoperative outcome wassatisfactory with a long-term graft patency. First JAcan be a reliable graft option for right hepatic arteryreconstruction.