scholarly journals One more anatomic variant of the celiac trunk(in French)

2019 ◽  
pp. 13-16

Anatomical variations of the celiac trunk are numerous. Variants of the hepatic artery are important to consider especially in the bilio-pancreatic procedures. Unusual arterial anatomy increases the risk of postoperative specific complications. We report a case of a rare anatomic variant of the celiac trunk that gives rise to a left and right hepatic artery separately. It is an exceptional variant found in a patient with a pancreatic head tumor and candidate for duodenopancreatectomy. Key words: celiac trunk, right hepatic artery, anatomic variant.

2019 ◽  
pp. 13-16

Anatomical variations of the celiac trunk are numerous. Variants of the hepatic artery are important to consider especially in the bilio-pancreatic procedures. Unusual arterial anatomy increases the risk of postoperative specific complications. We report a case of a rare anatomic variant of the celiac trunk that gives rise to a left and right hepatic artery separately. It is an exceptional variant found in a patient with a pancreatic head tumor and candidate for duodenopancreatectomy. Key words: celiac trunk, right hepatic artery, anatomic variant.


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.


Author(s):  
Silvio Marcio Pegoraro BALZAN ◽  
Vinicius Grando GAVA ◽  
Sabrina PEDROTTI ◽  
Marcelo Arbo MAGALHÃES ◽  
Alex SCHWENGBER ◽  
...  

ABSTRACT Background: Pancreaticoduodenectomy is the usual surgical option for curative treatment of periampullary cancer and carries a significant mortality. Arterial anomalies of the celiac axis are not uncommon and might lead to iatrogenic lesions or requiring arterial resection/reconstruction in a pancreatoduodenectomy. Aim: Determine the prevalence of arterial variations having implications in pancreatoduodenectomy. Methods: Celiac trunk and hepatic arterial system anatomy was retrospectively evaluated in 200 abdominal enhanced computed tomography studies. Results: Normal anatomy of hepatic arterial system was found in 87% of cases. An anomalous right hepatic artery was identified in 13% of cases. In 12 cases there was a substitute right hepatic artery arising from superior mesenteric artery and in two cases an accessory right hepatic artery with similar origin. A hepatomesenteric trunk was identified in seven cases and in five there was a right hepatic artery directly from the celiac trunk. All cases of anomalous right hepatic artery had a route was behind the pancreatic head and then, posteriorly and laterally, to the main portal vein before reaching the liver. Conclusions: Hepatic artery variations, such as anomalous right hepatic artery crossing posterior to the portal vein, are frequently seen (13%). These patients, when undergoing pancreatoduodenectomy, may require a change in the surgical approach to achieve an adequate resection. Preoperative imaging can clearly identify such variations and help to achieve a safer pancreatic head dissection with proper surgical planning.


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.


2020 ◽  
Vol 3 ◽  
Author(s):  
Alexander Huang ◽  
Ramana Yedavalli

Background:  Yttrium-90 microsphere embolization is a selective internal radiation therapy (SIRT) used in the treatment of hepatocellular carcinoma and liver metastases. Current literature recommends lobar, or more selective, infusion of SIRT to allow for precise radiation administration and to mitigate risk of non-target embolization. Lobar infusion requires knowledge of anatomical variations of hepatic arterial supply. The trifurcation of the celiac trunk into the left gastric artery, splenic artery, and common hepatic artery is the most common presentation representing 51% to 89% of patient anatomy. A replaced right hepatic artery (RHA) arising from the superior mesenteric artery (SMA) is one of the most common variants of hepatic arterial supply with a prevalence of 10.6% to 15%. Common variations such as these are well described and easily mapped using catheter angiography, but rarer variations are not as well described and more challenging to map.    Project Methods:  Mapping catheter angiogram of the celiac trunk and SMA was obtained. Additional aortogram and CT angiogram were obtained to further elucidate patient’s anatomy.    Results:  Initial mapping angiogram was only partially successful because the RHA could not be selected. Abdominal aortogram and CT angiogram of the abdomen and pelvis revealed a replaced RHA arising directly from the distal celiac trunk. Additionally, the patient had a replaced cystic artery arising from the left hepatic artery and an arc of Buhler connecting the proximal SMA to the proximal aspect of the right hepatic artery.    Conclusion:  Radiologists need to be aware of rare variations in hepatic arterial supply for the safe and effective treatment of hepatic neoplasms, whether primary or metastatic. Description of arterial variation and informed selection of arterial branches will remain a critical aspect of improving efficiency and reducing risks of hepatic embolization procedures. 


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.


2019 ◽  
Vol 36 (02) ◽  
pp. 126-128
Author(s):  
Cristiane Regina Ruiz ◽  
Sergio Ricardo Rios Nascimento ◽  
Alex Kors Vidsiunas ◽  
Cristiano Cirqueira de Souza ◽  
Lilian Andrades

AbstractAnatomical variations in the hepatic arteries and in the celiac trunk are important in liver transplants, laparoscopic surgeries, abdominal radiological interventions, and perforating injuries in the abdomen. The goal of the present report is to describe an abdominal vascular variation observed during a routine dissection in the Anatomy Laboratory of the Centro Universitário São Camilo, São Paulo, state of São Paulo, Brazil, in a male individual. The superior mesenteric artery had its origin in the celiac trunk and originated a right accessory hepatic artery that followed its path all the way to the liver. Several authors described variations in the origin and in the path of the hepatic artery and even created specific classifications. The advance of imaging methods that increase the number of studied individuals, without the need of dissection, aids exponentially the quantifying studies that seek to determine a pattern in the variations present in certain populations. The variations of the hepatic artery, as well as of the celiac trunk, have been extensively described in the literature; however, there is no pattern in the number of variations found both in the celiac trunk and in the regular hepatic artery, what leads to a need of description in each case found.


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