scholarly journals Variant anatomy of common hepatic artery and its branching pattern: a cadaveric study with clinical implication

2017 ◽  
Vol 5 (9) ◽  
pp. 3966 ◽  
Author(s):  
Swati Thamke ◽  
Pooja Rani
Keyword(s):  
Hepatic Artery ◽  
Abdominal Cavity ◽  
Gastric Surgery ◽  
Common Hepatic Artery ◽  
Infusion Therapy ◽  
Branching Pattern ◽  
Gastric Artery ◽  
The Common ◽  
Variant Anatomy ◽  
Formalin Fixed

Background: With the advent of new diagnostic, therapeutic and operative techniques within the abdominal cavity, a sound knowledge of the variant courses of the abdominal vessels become important for dealing clinicians, surgeons and interventional radiologists. Surgeons undertaking hepatobiliary and gastric surgery must be acquainted with the anatomy of common hepatic artery and should be able to recognize its multiple anatomical variants to avoid subsequent thrombosis leading to ischaemia of the liver or bile duct and stomach with distressing consequences. The present study was carried out to document the normal anatomy and different variations of the common hepatic artery and to evaluate the possible clinical implications.Methods: A total of 36 properly embalmed and formalin fixed cadavers were dissected in the abdominal region and viscera were mobilized to expose the origin of important branches of the common hepatic artery.Results: Classical branching pattern of common hepatic artery was seen in 91.66% cases. Origin of right hepatic artery from superior mesenteric artery and accessory cystic artery from gastroduodenal artery was seen in 2.77% cases. In 5.55% cases, right gastric artery originated from left hepatic artery.Conclusions: Knowledge of such variations will play a significant role in avoiding technical difficulties during infusion therapy and chemoembolization of neoplasm in the liver. It is also valuable in carrying out surgical intervention safely in the abdomen and also in the interpretation of angiographic reports.

The common hepatic artery arising from the left gastric artery

2010 ◽  
Vol 32 (7) ◽  
pp. 703-705 ◽  
Author(s):  
Yoshitaka Okada ◽  
Naoko Nishi ◽  
Yuka Matsuo ◽  
Takeyuki Watadani ◽  
Fumiko Kimura
Keyword(s):  
Hepatic Artery ◽  
Left Gastric Artery ◽  
Common Hepatic Artery ◽  
Gastric Artery ◽  
The Common

New method of hepatic artery reconstruction after its injury or resection.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16221-e16221
Author(s):  
Oksana V. Katelnitskaya ◽  
Oleg I. Kit ◽  
Yuriy A. Gevorkyan ◽  
Aleksandr V. Snezhko ◽  
Oleg Yu. Kaymakchi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Hepatic Artery ◽  
Left Gastric Artery ◽  
Common Hepatic Artery ◽  
Arterial Blood Flow ◽  
Gastric Artery ◽  
Arterial Blood ◽  
Iatrogenic Damage ◽  
The Common ◽  
Reduced Time

e16221 Background: Restoration the hepatic arterial blood flow is required in traumatic or iatrogenic damage to the hepatic artery and its branches, as well as in the planned resection of the hepatic artery with subsequent reconstruction. Various ways have been proposed to solve this problem: ligation of the hepatic artery and its branches, which is associated with an extremely high mortality rate, reaching 70%, and the need for extensive liver resections; portal vein arteriolization; transposition of the splenic artery with its severe complications (heart attack, abscess) or hepatic artery replacement sometimes are not available and imply aggressive anticoagulant therapy, which is often challenging after extensive oncological interventions. Prosthetic vascular grafts are associated with a high risk of infection. We propose replacement of the common hepatic artery defect by transposition of the left gastric artery and end-to-end anastomosis between the proximal end of the left gastric artery and the distal end of the hepatic artery. Methods: The proposed method was applied in 7 cancer patients - 4 cases of iatrogenic damage to the common hepatic artery in lymph node dissection of the hepatoduodenal ligament and 3 resection of the common hepatic artery with tumor infiltration. The mean age of patients was 53 years. 2 patients had surgery for gastric cancer, 5 - pancreatic cancer. Results: The vascular reconstruction lasted for 17 minutes. No thrombotic complications of the reconstruction area or liver necrosis in the postoperative period were registered. The main advantages of this method were the absence of synthetic materials or deficit blood supply to neighboring organs, and no need for extensive mobilization of the great vessels in other areas (renal artery, abdominal aorta). Conclusions: The proposed method for reconstruction of the hepatic artery allows performing a simple and adequate restoration of the hepatic arterial blood flow, reduced time of the vascular stage of the surgery and reduced incidence of postoperative complications associated with the vascular stage - reduced time of liver ischemia and reduced risk of thrombosis in the reconstruction area.

scholarly journals A rare anastomosis between the root of common hepatic artery and proper hepatic artery: implications for pancreaticoduodenectomy

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Takeshi Morinaga ◽  
Katsunori Imai ◽  
Keisuke Morita ◽  
Kenichiro Yamamoto ◽  
Satoshi Ikeshima ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Hepatic Artery ◽  
Pancreatic Head ◽  
Common Hepatic Artery ◽  
Arterial Flow ◽  
Anastomotic Site ◽  
Proper Hepatic Artery ◽  
Arterial Reconstruction ◽  
Hepatic Arterial Flow ◽  
The Common

Abstract Background Hepatic artery anomalies are often observed, and the variations are wide-ranging. We herein report a case of pancreatic cancer involving the common hepatic artery (CHA) that was successfully treated with pancreaticoduodenectomy (PD) without arterial reconstruction, thanks to anastomosis between the root of CHA and proper hepatic artery (PHA), which is a very rare anastomotic site. Case presentation A 78-year-old woman was referred to our department for the examination of a tumor in the pancreatic head. Contrast-enhanced computed tomography (CT) revealed a low-density tumor of 40 mm in diameter located in the pancreatic head. The involvement of the common hepatic artery (CHA), the root of the gastroduodenal artery (GDA), and portal vein was noted. Although such cases would usually require PD with arterial reconstruction of the CHA, it was thought that the hepatic arterial flow would be preserved by the anastomotic site between the root of the CHA and the PHA, even if the CHA was dissected without arterial reconstruction. PD with dissection of the CHA and PHA was safely completed without arterial reconstruction, and sufficient hepatic arterial flow was preserved through the anastomotic site between the CHA and PHA. Conclusion We presented an extremely rare case of an anastomosis between the CHA and PHA in a patient with pancreatic cancer involving the CHA. Thanks to this anastomosis, surgical resection was successfully performed with sufficient hepatic arterial flow without arterial reconstruction.

scholarly journals The Features of Extrahepatic Collateral Arteries Related to Hepatic Artery Occlusion and Benefits in the Transarterial Management of Liver Tumors

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Lin Yang ◽  
Xiao Ming Zhang ◽  
Yong Jun Ren ◽  
Nan Dong Miao ◽  
Xiao Hua Huang ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Liver Tumors ◽  
Left Gastric Artery ◽  
Artery Occlusion ◽  
Gastric Artery ◽  
Collateral Arteries ◽  
Hepatocellular Carcinomas ◽  
Collateral Artery ◽  
The Common ◽  
The One

Purpose. To investigate the extrahepatic collateral arteries related to hepatic artery occlusion (HAO) and to determine its benefits in the transarterial management of liver tumors.Methods and Findings. Eleven patients (7 hepatocellular carcinomas, 3 liver metastases, and 1 with hemangioma) with HAO confirmed with digital subtraction angiography (DSA) were admitted to our hospital. Of the 11 patients, 7 were men and 4 were women, with an average age of 41.5 ± 15.5 years (range: 29 to 70 years). DSA was performed to evaluate the collateral routes to the liver. In the 11 patients with HAO, DSA showed complete occlusion of the common hepatic artery in 9 patients and the proper hepatic artery (PHA) in 2 patients. Extrahepatic collateral arteries supplying the liver were readily evident. The collateral arteries originated from the superior mesenteric artery (SMA) in 8 patients, from the gastroduodenal artery in 2 patients, and from the left gastric artery (LGA) in 1 patient. Transcatheter treatment was successfully performed via the collateral artery in all patients except the one who had hemangioma.Conclusions. DSA is an effective method for detecting collateral circulation related to HAO and may provide information to guide transcatheter management decisions.

scholarly journals Arterial diameter of the celiac trunk and its branches: anatomical study

2009 ◽  
Vol 24 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Luís Augusto da Silveira ◽  
Fernando Braga Cassiano Silveira ◽  
Valéria Paula Sassoli Fazan
Keyword(s):  
Hepatic Artery ◽  
Celiac Trunk ◽  
Anatomical Study ◽  
Anatomical Variations ◽  
Left Gastric Artery ◽  
Gastric Artery ◽  
Arterial Diameter ◽  
Significant Difference ◽  
Diameter Reduction ◽  
Formalin Fixed

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.

Unusual course of the common hepatic artery originating from the celiac trunk

2010 ◽  
Vol 32 (9) ◽  
pp. 883-885 ◽  
Author(s):  
Mo Jin Wang ◽  
Zhong Cheng ◽  
Rui Wang ◽  
Yuan Li ◽  
Zong Guang Zhou
Keyword(s):  
Hepatic Artery ◽  
Celiac Trunk ◽  
Common Hepatic Artery ◽  
The Common

scholarly journals Hepatic Artery Embolization prior to En Bloc Resection of an Encased Common Hepatic Artery in Adenocarcinoma of the Head of the Pancreas

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Gregory Sergeant ◽  
Erik Schadde ◽  
Geert Maleux ◽  
Raymond Aerts
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Balloon Dilation ◽  
En Bloc Resection ◽  
Common Hepatic Artery ◽  
Pathological Examination ◽  
Periampullary Cancer ◽  
En Bloc ◽  
Head Of The Pancreas ◽  
The Common

A 64-year-old female patient with adenocarcinoma of the head of the pancreas with encasement of the common hepatic artery and portal vein stenosis was reexplored after six cycles of gemcitabine (1000 mg/m2). Prior to surgery, the patient underwent balloon dilation and stenting of the portal vein in addition to successful coil embolisation of the common hepatic artery, proper hepatic artery, and proximal gastroduodenal artery. After embolisation, a pylorus-preserving pancreaticoduodenectomy was performed with resection of the common hepatic artery and portal vein confluens. Pathological examination showed a moderately differentiated pT3N0 (Stage IIa, TNM 7th edition) tumor with negative section margins. We show with this case that in selected cases of periampullary cancer with encasement of the common hepatic artery, it is technically feasible to perform pancreaticoduodenectomy with hepatic artery resection and negative surgical margins. Nevertheless, the oncological benefit of extended arterial resections remains controversial.

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