An Aberrant Origin of the Right Hepatic Artery: A Rare Anatomic Variation. And Its Clinical Application
- 1 Department of Anatomy, College of Medicine, King Saud University, Riyadh, KSA
Abstract
The right hepatic artery is an important arterial supply to right lobe of the liver. And the knowledge of the normal anatomy and anatomical variations of the right hepatic artery is essential to perfume, and will minimize morbidity, and also help to decrease the number of complications of hepatobiliary surgery. This study was conducted on eleven human cadavers, which were obtained from the routine autopsies at the dissection room of the Anatomy Department. During dissection of the eleven cadaveric livers, we found a case with an ex-ceptional anatomic variation; a replaced right hepatic artery (RRHA) coming off the superior mesenteric artery (SMA), directly to the hepatic right lobe passing through the Calot’s triangle, crossing behind the common hepatic duct (CHD). Our objective is to draw much attention to this particularly anatomic variation of the origin of the RRHA as well as its clinical importance in order to ensure that no damage will be made during gastrointestinal and hepatobiliary surgery.
- Standring, S. (2008) Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 40th Edition, Churchill Livingstone, New York.
- Hollinshead, W.H. (1971) Anatomy for Surgeons: The Thorax Abdomen and Pelvis. 2nd Edition, Harper and Row, New York.
- Xu, X. and Zheng, S. (2006) Variations and Reconstruction of the Hepatic Artery in Liver Transplantation. Hepatobiliary & Pancreatic Diseases International, 15, 170-172.
- Aramaki, O., Sugawara, Y., Kokudo, N., Takayama, T. and Makuuchi, M. (2006) Branch Patch Reconstruction in Living Donor Liver Transplantation: Arterialization of Grafts with Replaced Type Arteries. Transplantation, 82, 1541-1543. https://doi.org/10.1097/01.tp.0000236102.36326.a6
- Suzuki, T., Nakayasu, A., Kawabe, K., Takeda, H. and Honjo, I. (1971) Surgical Significance of Anatomic Variations of the Hepatic Artery. American Journal of Surgery, 122, 505-512. https://doi.org/10.1016/0002-9610(71)90476-4
- Jones, R.M. and Hardy, K.J. (2001) The Hepatic Artery; A Reminder of Surgical Anatomy. Journal of Royal College of Surgeons of Edinburgh, 46, 168-170. https://doi.org/10.1016/0002-9610(71)90476-4
- Bhardwaj, N. (2010) Anomalous Origins of Hepatic Artery and Its Significance for Hepatobiliary Surgery. Journal of the Anatomical Society of India, 59, 173-176. https://doi.org/10.1016/S0003-2778(10)80020-6
- Michels, N.A. (1966) Newer Anatomy of the Liver and Its Variant Blood Supply and Collateral Circulation. American Journal of Surgery, 112, 337-347. https://doi.org/10.1016/0002-9610(66)90201-7
- Paraskevas, G.K. and Raikos, A. (2011) Multiple Aberrant Coeliac Trunk Ramifications. Singapore Medical Journal, 52, e147-e149.
- Hiatt, J.R., Gabbay, J. and Busuttil, R.W. (1994) Surgical Anatomy of the Hepatic Arteries in 1000 Cases. Annals of Surgery, 220, 50-52. https://doi.org/10.1097/00000658-199407000-00008
- Shukla, P.J., Barreto, S.G., Kulkarni, A., Nagarajan, G. and Fingerhut, A. (2010) Vascular Anomalies Encountered during Pancreatoduodenectomy: Do They Influence Outcomes? Annals of Surgical Oncology, 17, 186-193. https://doi.org/10.1245/s10434-009-0757-1
- Kosaka, M., Horiuchi, K., Nishida, K., Taguchi, T., Murakami, T. and Ohtsuka, A. (2002) Hepatopancreatic Arterial Ring: Bilateral Symmetric Typology in Human Celiaco-Mesenteric Arterial System. Acta Medica Okayama, 56, 245-253.