scholarly journals Anatomy of the vasculature supplying hepatobiliary structures and celiac trunk branching patterns in the Thai population

2019 ◽  
Vol 12 (4) ◽  
pp. 161-167
Author(s):  
Natcha Nateniyom ◽  
Thanasil Huanmanop ◽  
Sithiporn Agthong ◽  
Vilai Chentanez

AbstractBackgroundKnowledge of the anatomy of the celiac trunk (CT) and arterial supply of the hepatobiliary system is essential for surgical and interventional radiological treatment of upper abdominal diseases.ObjectivesTo determine the branching patterns of the CT and variation in origin and type of the right hepatic artery (RHA), left hepatic artery (LHA), and cystic artery (CA).MethodsThe anatomy of the CT in 100 cadavers from Thai adult donors was observed in 3 aspects: its branching pattern, the origin of the RHA and LHA, and the origin of the CA and its relation to the common bile duct (CBD) and common hepatic duct (CHD).ResultsThe majority of the CT branching pattern was categorized as the type II classical pattern, which has 3 branches: the left gastric artery (LGA), splenic artery (SA), and common hepatic artery (CHA). The RHA branched from proper hepatic artery in 67 cadavers. The origin of the accessory RHA was either from the abdominal aorta or superior mesenteric artery (SMA), whereas the replaced RHA originated from the CHA, SMA, or CT. The accessory LHA ramified from CHA (2 cases) and LGA (1 case). The replaced LHA was found in 30 cadavers and 29 arose from the CHA. The single and double types of CA were found in 94 and 4 cadavers, respectively. In all, 57% of single CA passed posteriorly and 39% passed anteriorly to the CBD and CHD.ConclusionsTo lower posttreatment complications, variations in the anatomy and the vascular supply of hepatobiliary structures should be considered.

1984 ◽  
Vol 35 (3) ◽  
pp. 455-468 ◽  
Author(s):  
A.B. Boekelaar ◽  
B. Baljet ◽  
J. Drukker

In this study the arterial vascular supply of the upper abdominal organs in the rat was investigated. In general the main anatomical features seem to be in accordance with the anatomy in man. However there are some important differences worth mentioning and the nomenclature used in the rat is not adequate in all respects: 1. The branch of the celiac artery which bifurcates into the hepatic artery proper and the gastroduodenal artery should not be given the incorrect name hepatic artery but is named common hepatic artery. 2. The hepato-esophageal artery is a constantly present branch of the hepatic artery proper running in the hepatogastric ligament. 3. The right gastric artery, present in about 40% of the specimens, is a branch of the gastroduodenal artery which runs towards the lesser curvature where it communicates freely with a left gastric artery branch. 4. The gastrosplenic artery is one of the branches of the splenic artery. It divides into a gastric and a splenic branch. The gastric branch is the only short gastric artery present in the rat. 5. A gastro-epiploic artery at the splenic side of the stomach is not present in the rat. The continuation of the splenic artery into the greater omentum has been referred to as the left epiploic artery. Anastomoses with epiploic branches of the gastro-epiploic artery are present in the greater omentum.


2015 ◽  
Vol 32 (03) ◽  
pp. 200-202
Author(s):  
S. Nayak ◽  
A. Aithal ◽  
S. Shetty ◽  
N. Kumar ◽  
S. Ravindra ◽  
...  

AbstractArterial supply for the derivatives of foregut in the abdomen is provided by the branches of the celiac trunk. Celiac trunk is the first ventral branch of abdominal aorta and usually branches into splenic, common hepatic and left gastric arteries. Variations in the branching pattern of celiac trunk are common but in most of the people, they remain asymptomatic and go unnoticed. A good knowledge of these anatomical variations is important for surgeons undertaking various surgeries in the abdominal region and will help to minimise the complications related to abdominal surgery. Clinicians and radiologists should also be aware of any variations in the vascular pattern of the celiac trunk before performing angiographic examinations. In the current case, the celiac trunk divided into two branches; left gastric artery and hepato-splenic trunk. The hepato-splenic trunk further divided into splenic and common hepatic arteries. The common hepatic artery trifitrcated into proper hepatic, gastroduodenal and accessory hepatic arteries. Hepatic artery proper divided into right and left hepatic arteries. The accessory hepatic artery was tortuous and was as large as the left hepatic artery. It gave origin to the right gastric artery and entered the liver through left end of porta hepatis.


2021 ◽  
pp. 45-47
Author(s):  
Sabeersha. S ◽  
K.S. Krishnakumari

The right hepatic artery is an end artery and contributes sole arterial supply to right lobe of the liver . It also supplies the gall bladder, cystic duct, common hepatic duct and upper and middle part of common bile duct. Normal hepatic arterial anatomy occurs in approximately in 80% of cases, for the remaining 20% multiple variations have been described. Misinterpretation of anatomical variations of the right hepatic artery contribute to the major intraoperative mishaps and complications in hepatobiliary surgery. Materials and Methods: This descriptive study conducted on 50 cadavers in Department of Anatomy,Govt Medical College, Kozhikode to document the normal anatomy and different variations of right hepatic artery regarding its origin and relation with the common hepatic duct. Results : Right hepatic artery had its origin from proper hepatic artery in 47 (94%) cases, in one case the artery came from common hepatic artery, aberrant origin of right hepatic artery was seen in 4% cases, one case from celiac trunk directly and the other from superior mesenteric artery. Relation with common hepatic duct : In 46 cases (92%) the artery (normal and aberrant) passes posterior to common hepatic duct. In 6%, the artery was related anterior to common hepatic duct. In one case the artery was medial to the common hepatic duct. Conclusions : This study highlights the importance of knowledge of such anomalies since their awareness will decrease morbidity and help to keep away from a number of surgical complications.


Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2262
Author(s):  
Kapil Kumar Malviya ◽  
Ashish Verma ◽  
Amit Kumar Nayak ◽  
Anand Mishra ◽  
Raghunath Shahaji More

Understanding of variations in the course and source of abdominal arteries is crucial for any surgical intervention in the peritoneal space. Intricate surgeries of the upper abdominal region, such as hepato-biliary, pancreatic, gastric and splenic surgeries, require precise knowledge of regular anatomy and different variations related to celiac trunk and hepatic artery. In addition, information about the origin of inferior phrenic artery is important in conditions such as hepatocellular carcinoma and gastroesophageal bleeding management. The present study gives an account of anatomical variations in origin and branching pattern of celiac trunk and hepatic artery by the use of CT (computed tomographic) angiography. The study was performed on 110 (66 females and 44 males) patients in a north Indian population. Results unraveled the most common celiac trunk variation as hepatosplenic trunk with left gastric artery, which was observed in 60% of cases, more common in females than in males. Gastrosplenic and hepato-gastric trunk could be seen in 4.55% and 1.82% cases respectively. Gastrosplenic trunk was more commonly found in females, whereas hepato-gastric trunk was more common in males. A gastrosplenic trunk, along with the hepato-mesenteric trunk, was observed in 1.82% cases and was more common in males. A celiacomesenteric trunk, in which the celiac trunk and superior mesenteric artery originated as a common trunk from the aorta, was seen only in 0.91% of cases, and exhibited an origin of right and left inferior phrenic artery from the left gastric artery. The most common variation of hepatic artery, in which the right hepatic artery was replaced and originated from the superior mesenteric artery, was observed in 3.64%, cases with a more common occurrence in males. In 1.82% cases, the left hepatic artery was replaced and originated from the left gastric artery, which was observed only in females. Common hepatic artery originated from the superior mesenteric artery, as observed in 1.82% cases, with slightly higher occurrence in males. These findings not only add to the existing knowledge apart from giving an overview of variations in north Indian population, but also give an account of their correlation with gender. The present study will prove to be important for various surgeries of the upper abdominal region.


2009 ◽  
Vol 24 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Luís Augusto da Silveira ◽  
Fernando Braga Cassiano Silveira ◽  
Valéria Paula Sassoli Fazan

PURPOSE: Despite the fact that anatomical variations of the celiac trunk are well explored in the literature, information on these vessels diameters is scanty. The aims of the present study were to describe the arterial diameters of the celiac trunk and its main branches, and to investigate if these diameters are altered in those cases presenting anatomical variations of these vessels. METHODS: Twenty-one formalin fixed adult male cadavers were appropriately dissected for the celiac trunk identification and arterial diameter measurements. Arteries measured included the celiac trunk and its main branches (splenic artery, left gastric artery and common hepatic artery), as the proper hepatic artery, right gastric artery, the left and right hepatic arteries and the gastroduodenal artery. RESULTS: From the 21 cadavers, 6 presented anatomical variations of, at least, one of the above mentioned branches. The average arterial diameter comparisons between groups (normal and variable) clearly showed smaller diameters for variable vessels, but with no significant difference. CONCLUSION: Our data indicates the possibility of a diameter reduction of the celiac trunk main branches in the presence of anatomical variations. This should be taken into account on the selection for the liver transplantation donors.


2020 ◽  
pp. 1-3
Author(s):  
Ilgar Aghalarov ◽  
Theodor Lutz ◽  
Waldemar Uhl ◽  
Orlin Belyaev

An anomalous anatomy of the celiac trunk, and particularly of the right hepatic artery, may have a significant impact on major hepatobiliary and pancreatic surgery. According to some authors, every third patient has an aberrant right hepatic artery. We present a very rare case of replaced right hepatic artery (RRHA) arising from the gastroduodenal artery associated with an accessory left hepatic artery originating from the left gastric artery in a 54-year-old woman with a pancreatic head carcinoma. The patient underwent total pancreatectomy on account of a soft lipomatous pancreas with heterogeneous changes of the pancreatic body and tail. We preserved the RRHA and achieved R0 resection margins. Preoperative evaluation of CT angiograms, an awareness of any anomalous arterial anatomy of the upper abdomen, and a meticulous surgical technique are the key to performing oncologically radical surgery without threatening the arterial liver supply.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Usha Dandekar ◽  
Kundankumar Dandekar ◽  
Sushama Chavan

The right hepatic artery is an end artery and contributes sole arterial supply to right lobe of the liver. Misinterpretation of normal anatomy and anatomical variations of the right hepatic artery contribute to the major intraoperative mishaps and complications in hepatobiliary surgery. The frequency of inadvertent or iatrogenic hepatobiliary vascular injury rises with the event of an aberrant anatomy. This descriptive study was carried out to document the normal anatomy and different variations of right hepatic artery to contribute to existing knowledge of right hepatic artery to improve surgical safety. This study conducted on 60 cadavers revealed aberrant replaced right hepatic artery in 18.3% and aberrant accessory right hepatic artery in 3.4%. Considering the course, the right hepatic artery ran outside Calot’s triangle in 5% of cases and caterpillar hump right hepatic artery was seen in 13.3% of cases. The right hepatic artery (normal and aberrant) crossed anteriorly to the common hepatic duct in 8.3% and posteriorly to it in 71.6%. It has posterior relations with the common bile duct in 16.7% while in 3.4% it did not cross the common hepatic duct or common bile duct. The knowledge of such anomalies is important since their awareness will decrease morbidity and help to keep away from a number of surgical complications.


2021 ◽  
Vol 10 (37) ◽  
pp. 3225-3230
Author(s):  
Vidya C.S ◽  
Shivanakarappa C. ◽  
Sudha Kiran Das ◽  
Santh Kumar

BACKGROUND Celiac trunk (CT) is the first major abdominal branch of the aorta. Anatomic variations and accessory vessels have been reported with variable percentages. We report here a particularly rare variant involving absence of the celiac trunk in association with trifurcation of the common hepatic artery (CHA). The purpose of this study was to report the pattern of the celiac trunk and its anatomic variations in a sample of Mysore population. METHODS Celiac trunk dissection was performed in 10 fresh cadavers and 50 cases of contrast enhanced computed tomography (CECT) images of Mysore based subjects at JSS Medical College and Hospital aged 18 years and above were included. Celiac trunk variations, length, diameter, accessory vessels, and vertebral level of origin were described. RESULTS The branching pattern of coeliac trunk was observed in 60 cases (37 males, 23 females) by dissection and CECT scan method. Type I was found in 48 cases (80 %), Type I form 2a was found in 2 cases (3.3 %). Type II form 1 in 6 cases (10 %). Type III was observed in 1 case and in another case left hepatic artery (LHA) arising from coeliac trunk, Type VII was found in 2 cases (3.3 %). The length and diameter of coeliac trunk were analysed using descriptive statistics and mean ± SD for length was 1.8 ± 0.4 and diameter 0.5 ± 0.2 respectively. CONCLUSIONS Awareness of CT variations is important in surgical resection, transplantation, and interventional radiology procedure. KEY WORDS Celiac Trunk, Variations, Morphometry, Contrast Enhanced Computed Tomography Scan Method


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