Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492010005000006
Jornal Vascular Brasileiro
Original Article

Accessory hepatic artery: incidence and distribution

Artéria hepática acessória: incidência e distribuição

Sukhendu Dutta; Bimalendu Mukerjee

http://dx.doi.org/10.1590/S1677-54492010005000006 J Vasc Bras, vol.9, n1, p.25-27, 2010
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Abstract

Background: Anatomic variations of the hepatic arteries are common. Preoperative identification of these variations is important to prevent inadvertent injury and potentially lethal complications during open and endovascular procedures. Objective: To evaluate the incidence, extra-hepatic course, and presence of side branches of accessory hepatic arteries, defined as an additional arterial supply to the liver in the presence of normal hepatic artery. Methods: Eighty-four human male cadavers were dissected using a transperitoneal midline laparotomy. The supra-celiac aorta, celiac axis, and hepatic arteries were dissected, and their trajectories were identified to describe arterial branching patterns. Results: Normal hepatic arterial anatomy was identified in 95% of the cadavers and six (5%) had accessory hepatic arteries. In five cadavers the accessory hepatic artery followed its course through the fissure for ligamentum venosum, and in one it coursed adjacent to the hepatic artery through the margin of the lesser omentum. One cadaver had a single side branch, which provided arterial blood supply to the left adrenal gland in the absence of any left inferior phrenic artery. Conclusion: Accessory hepatic artery most often follows the course of the hepatic fissure for ligamentum venosum. Albeit uncommonly found in 5% of cases, this finding should be identified during open and endovascular procedures to prevent inadvertent injury.

Keywords

Liver-arterial supply, celiac trunk, accessory hepatic artery, suprarenal artery

Resumo

Contexto: As variações anatômicas das artérias hepáticas são comuns. A identificação pré-operatória dessas variações é importante para prevenir lesão inadvertida e complicações potencialmente letais durante procedimentos abertos e endovasculares. Objetivo: Avaliar a incidência, o trajeto extra-hepático e a presença de ramos laterais das artérias hepáticas acessórias definidas como um suprimento arterial adicional para o fígado na presença de artéria hepática normal. Métodos: Oitenta e quatro cadáveres humanos masculinos foram dissecados através de laparotomia mediana transperitoneal. A aorta supracelíaca, o eixo celíaco e as artérias hepáticas foram dissecados, e suas trajetórias foram identificadas para descrever os padrões dos ramos arteriais. Resultados: Anatomia arterial hepática normal foi identificada em 95% dos cadáveres, e seis (5%) tinha artérias hepáticas acessórias. Em cinco cadáveres, a artéria hepática acessória seguia seu trajeto através da fissura para o ligamento venoso, e em um caso a artéria corria adjacente à artéria hepática através da margem do pequeno omento. Um cadáver tinha um ramo unilateral que fornecia sangue arterial para a glândula adrenal esquerda na ausência de qualquer artéria frênica inferior esquerda. Conclusão: A artéria hepática acessória frequentemente segue o trajeto da fissura hepática para o ligamento venoso. Embora comumente encontrado em 5% dos casos, esse achado deve ser identificado durante procedimentos abertos e endovasculares para prevenir lesão inadvertida.

Palavras-chave

Suprimento arterial hepático, tronco celíaco, artéria hepática acessória, artéria suprarrenal

References

Weiglein AH. Variations and topography of the arteries in the lesser omentum in humans. Clin Anat. 1996;9:143-50.

Sahani D, Sanjay S, Constantino P. Using multidetector CT for preoperative vascular evaluation of liver neoplasms: technique and results. Am J Roentgenol. 2002;179:53-9.

Hiatt JR, Gabbay J, Busutil RW. Surgical anatomy of the hepatic arteries in 1000 cases. Ann Surg. 1994;220:50-2.

Chuang VP, Wallace S. Hepatic arterial redistribution for intra arterial infusion of hepatic neoplasms. Radiology. 1980;135:295-9.

Volpe CM, Peterson S, Hoover EL, Doerr RJ. Justification for visceral angiography prior to pancreaticoduodenectomy. Am Surg. 1998;64:758-61.

Santis De M, Ariosi P, Calò GF, Romagnoli R. Hepatic arterial vascular anatomy and its variants. Radiol Med. 2000;100:145-51.

Gruttadauria S, Foglieni CS, Doria C, Luca A, Lauro A, Marino IR. The hepatic artery in liver transplantation and surgery: vascular anomalies in 701 cases. Clin Transplant. 2001;15:359-63.

Jones RM, Hardy KJ. The hepatic artery: a reminder of surgical anatomy. J R Coll Surg Edinb. 2001;46:168-70.

Allen PJ, Stojadinovic A, Ben-Porat L. The management of variant arterial anatomy during hepatic arterial infusion pump placement. 2002;9:875-80.

Abdullah SS, Mabrut JY, Garbit V. Anatomical variations of the hepatic artery: study of 932 cases in liver transplantation. Surg Radiol Anat. 2006;28:468-73.

Mäkisalo H, Chaib E, Nikos K, Calne R. Hepatic arterial variations and liver-related diseases of 100 consecutive donors. 2008;6:325-9.

Standring S. Gray’s anatomy: the anatomical basis of clinical practice. 2005:1218.

Sinnatamby CS. Last’s anatomy: regional and applied. 2006:273.

Kulesza RJ Jr, Kalmey JK, Dudas B, Buck WR. Vascular anomalies in a case of situs inversus. Folia Morphol. 2007;60:69-73.

Skandalakis JE, Skandalakis PN, Skandalakis LJ. Surgical Anatomy and technique: a pocket manual. 2002:537.

Michels NA. Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg. 1962;112:337-47.

Niederhuber JE, Ensminger WD. Surgical considerations in the management of hepatic neoplasia. Semin Oncol. 1983;10:135-47.

Kemeny MM, Hogan JM, Goldberg DA. Continuous hepatic artery infusion with an implantable pump: problems with hepatic arterial anomalies. Surgery. 1986;99:501-4.

Brems JJ, Millis JM, Hiatt JR. Hepatic artery reconstruction during liver transplantation. Transplantation. 1989;47:403-6.

Braun MA, Collins MB, Wright P. An aberrant right hepatic artery from the right renal artery: anatomical vignette. Cardiovasc Intervent Radiol. 1991;14:349-51.

Pai RS, Hunnargi AS, Srinivasan M. Accessory left hepatic artery arising from common hepatic artery. Indian J Surg. 2008;70:80-2.

Plakunta T, Potu BK, Gorantla VR, Vollala VR, Thomas J. Surgical importance of variant hepatic blood vessels: a case report. J Vasc Bras. 2008;7:84-86.

Gordon DH, Martin EC, Kim YH, Kutcher R. Accessory blood supply to the liver from the dorsal pancreatic artery: an unusual anatomic variant. Cardiovasc Radiol. 1978;1:199-201.

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