Skip to main content
Top
Published in: Surgical and Radiologic Anatomy 7/2016

01-09-2016 | Anatomic Variations

Right hepatic artery from splenic artery: the four-leaf clover of hepatic surgery

Authors: Francesco Caruso, Daniele Dondossola, Gianluca Fornoni, Lucio Caccamo, Giorgio Rossi

Published in: Surgical and Radiologic Anatomy | Issue 7/2016

Login to get access

Abstract

The anatomy of hepatic arteries is one of the most variable. Accurate awareness of all the possible anatomic variations is crucial in the upper GI surgery and especially in liver and pancreas transplantation. The most frequent anatomical variants are: a replaced or accessory right hepatic artery (RHA) from the superior mesenteric artery (6.3–21 %), a replaced or accessory left hepatic artery (LHA) from the left gastric artery (LGA) (3–18 %) or a combination of these two variants (up to 7.4 %). Herein, we describe the case of a 67-year-old cadaveric organ donor who presented a RHA originating from the splenic artery (SA) associated with both a CHA originating from the celiac trunk (CT) and a LHA originating from the LGA.
Literature
1.
go back to reference Allen PJ, Stojadinovic A, Ben-Porat L et al (2002) The management of variant arterial anatomy during hepatic arterial infusion pump placement. Ann Surg Oncol 9:875–880CrossRefPubMed Allen PJ, Stojadinovic A, Ben-Porat L et al (2002) The management of variant arterial anatomy during hepatic arterial infusion pump placement. Ann Surg Oncol 9:875–880CrossRefPubMed
3.
go back to reference Burke D, Earlam S, Fordi C, Allen-Mersh TG (1995) Effect of aberrant hepatic arterial anatomy on tumor response to hepatic artery infusion of floxuridine for colorectal liver metastases. Br J Surg 82:1098–1100CrossRefPubMed Burke D, Earlam S, Fordi C, Allen-Mersh TG (1995) Effect of aberrant hepatic arterial anatomy on tumor response to hepatic artery infusion of floxuridine for colorectal liver metastases. Br J Surg 82:1098–1100CrossRefPubMed
4.
go back to reference Coşkun M, Kayahan EM, Ozbek O et al (2005) Imaging of hepatic arterial anatomy for depicting vascular variations in living related liver transplant donor candidates with multidetector computed tomography: comparison with conventional angiography. Transpl Proc 37:1070–1073CrossRef Coşkun M, Kayahan EM, Ozbek O et al (2005) Imaging of hepatic arterial anatomy for depicting vascular variations in living related liver transplant donor candidates with multidetector computed tomography: comparison with conventional angiography. Transpl Proc 37:1070–1073CrossRef
5.
go back to reference Covey AM, Brody LA, Maluccio MA et al (2002) Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients. Radiology 224:542–547CrossRefPubMed Covey AM, Brody LA, Maluccio MA et al (2002) Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients. Radiology 224:542–547CrossRefPubMed
6.
go back to reference Curley SA, Chase JL, Roh MS et al (1993) Technical consideration and complications associated with the placement of 180 implantable hepatic arterial infusion devices. Surgery 114:928–935PubMed Curley SA, Chase JL, Roh MS et al (1993) Technical consideration and complications associated with the placement of 180 implantable hepatic arterial infusion devices. Surgery 114:928–935PubMed
7.
go back to reference De Cecco CN, Ferrari R, Rengo M et al (2009) Anatomic variations of the hepatic arteries in 250 patients studied with 64-row CT angiography. Eur Radiol 19:2765–2770CrossRefPubMed De Cecco CN, Ferrari R, Rengo M et al (2009) Anatomic variations of the hepatic arteries in 250 patients studied with 64-row CT angiography. Eur Radiol 19:2765–2770CrossRefPubMed
8.
go back to reference De Santis M, Ariosi P, Calò GF et al (2000) Hepatic arterial vascular anatomy and its variants. Radiol Med 100:145–151PubMed De Santis M, Ariosi P, Calò GF et al (2000) Hepatic arterial vascular anatomy and its variants. Radiol Med 100:145–151PubMed
9.
go back to reference Egorov VI, Yashina NI, Fedorov AV et al (2010) Celiaco-mesenterial arterial aberrations in patients undergoing extended pancreatic resections: correlation of CT angiography with findings at surgery. JOP 11:348–357PubMed Egorov VI, Yashina NI, Fedorov AV et al (2010) Celiaco-mesenterial arterial aberrations in patients undergoing extended pancreatic resections: correlation of CT angiography with findings at surgery. JOP 11:348–357PubMed
10.
go back to reference Gruttadauria S, Foglieni CS, Doria C et al (2001) The hepatic artery in liver transplantation and surgery: vascular anomalies in 701 cases. Clin Transpl 15:359–363CrossRef Gruttadauria S, Foglieni CS, Doria C et al (2001) The hepatic artery in liver transplantation and surgery: vascular anomalies in 701 cases. Clin Transpl 15:359–363CrossRef
11.
go back to reference Gümüs H, Bükte Y, Özdemir E et al (2013) Variations of the celiac trunk and hepatic arteries: a study with 64-detector computed tomographic angiography. Eur Rev Med Pharmacol Sci 17:1636–1641PubMed Gümüs H, Bükte Y, Özdemir E et al (2013) Variations of the celiac trunk and hepatic arteries: a study with 64-detector computed tomographic angiography. Eur Rev Med Pharmacol Sci 17:1636–1641PubMed
12.
go back to reference Hardy KJ, Jones RM (1994) Hepatic artery anatomy in relation to reconstruction in liver transplantation: some unusual variations. Aust N Z J Surg 64:437–440CrossRefPubMed Hardy KJ, Jones RM (1994) Hepatic artery anatomy in relation to reconstruction in liver transplantation: some unusual variations. Aust N Z J Surg 64:437–440CrossRefPubMed
14.
go back to reference Kemeny MM, Hogan JM, Goldberg DA et al (1986) Continuous hepatic artery infusion with an implantable pump: problems with hepatic artery anomalies. Surgery 99:501–504PubMed Kemeny MM, Hogan JM, Goldberg DA et al (1986) Continuous hepatic artery infusion with an implantable pump: problems with hepatic artery anomalies. Surgery 99:501–504PubMed
15.
go back to reference Koops A, Wojciechowski B, Broering DC et al (2004) Anatomic variations of the hepatic arteries in 604 selective celiac and superior mesenteric angiographies. Surg Radiol Anat 26:239–244CrossRefPubMed Koops A, Wojciechowski B, Broering DC et al (2004) Anatomic variations of the hepatic arteries in 604 selective celiac and superior mesenteric angiographies. Surg Radiol Anat 26:239–244CrossRefPubMed
16.
go back to reference Lopez-Andujar R, Moya A, Montalva E et al (2007) Lessons learned from anatomic variants of the hepatic artery in 1081 transplanted livers. Liver Transpl 13:1401–1404CrossRefPubMed Lopez-Andujar R, Moya A, Montalva E et al (2007) Lessons learned from anatomic variants of the hepatic artery in 1081 transplanted livers. Liver Transpl 13:1401–1404CrossRefPubMed
17.
go back to reference Löschner C, Nagel SN, Kausche S et al (2015) Hepatic arterial supply in 1297 CT-angiographies. Rofo 187:276–282CrossRefPubMed Löschner C, Nagel SN, Kausche S et al (2015) Hepatic arterial supply in 1297 CT-angiographies. Rofo 187:276–282CrossRefPubMed
18.
go back to reference Mäkisalo H, Chaib E, Krokos N et al (1993) Hepatic arterial variations and liver-related diseases of 100 consecutive donors. Transpl Int 6:325–329CrossRefPubMed Mäkisalo H, Chaib E, Krokos N et al (1993) Hepatic arterial variations and liver-related diseases of 100 consecutive donors. Transpl Int 6:325–329CrossRefPubMed
19.
go back to reference Michels NA (1962) Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg 112:337–347CrossRef Michels NA (1962) Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg 112:337–347CrossRef
20.
go back to reference Niederhuber JE, Ensminger WD (1983) Surgical consideration in the management of hepatic neoplasia. Semin Oncol 10:135–147PubMed Niederhuber JE, Ensminger WD (1983) Surgical consideration in the management of hepatic neoplasia. Semin Oncol 10:135–147PubMed
21.
go back to reference Rong GH, Sindelar WF (1987) Aberrant peripancreatic arterial anatomy: consideration in performing pancreatectomy for malignant neoplasms. Am Surg 53:726–729PubMed Rong GH, Sindelar WF (1987) Aberrant peripancreatic arterial anatomy: consideration in performing pancreatectomy for malignant neoplasms. Am Surg 53:726–729PubMed
22.
go back to reference Rygaard H, Forrest M, Mygind T et al (1986) Anatomic variants of the hepatic arteries. Acta Radiol Diagn (Stockh) 27:425–427 Rygaard H, Forrest M, Mygind T et al (1986) Anatomic variants of the hepatic arteries. Acta Radiol Diagn (Stockh) 27:425–427
23.
go back to reference Saba L, Mallarini G (2011) Anatomic variations of arterial liver vascularization: an analysis by using MDCTA. Surg Radiol Anat 33:559–568CrossRefPubMed Saba L, Mallarini G (2011) Anatomic variations of arterial liver vascularization: an analysis by using MDCTA. Surg Radiol Anat 33:559–568CrossRefPubMed
24.
go back to reference Soin AS, Friend PJ, Rasmussen A et al (1996) Donor arterial variations in liver transplantation: management and outcome of 527 consecutive grafts. Br J Surg 83:637–641CrossRefPubMed Soin AS, Friend PJ, Rasmussen A et al (1996) Donor arterial variations in liver transplantation: management and outcome of 527 consecutive grafts. Br J Surg 83:637–641CrossRefPubMed
25.
go back to reference Stemmler BJ, Paulson EK, Thornton FJ et al (2004) Dual-phase 3D MDCT angiography for evaluation of the liver before hepatic resection. Am J Roentgenol 183:1551–1557CrossRef Stemmler BJ, Paulson EK, Thornton FJ et al (2004) Dual-phase 3D MDCT angiography for evaluation of the liver before hepatic resection. Am J Roentgenol 183:1551–1557CrossRef
26.
go back to reference Suzuki T, Nakayasu A, Kawabe K et al (1971) Surgical significance of anatomic variations of the hepatic artery. Am J Surg 122:505–512CrossRefPubMed Suzuki T, Nakayasu A, Kawabe K et al (1971) Surgical significance of anatomic variations of the hepatic artery. Am J Surg 122:505–512CrossRefPubMed
27.
go back to reference Varotti G, Gondolesi GE, Goldman J et al (2004) Anatomic variations in right liver living donors. J Am Coll Surg 198:577–582CrossRefPubMed Varotti G, Gondolesi GE, Goldman J et al (2004) Anatomic variations in right liver living donors. J Am Coll Surg 198:577–582CrossRefPubMed
28.
go back to reference Winston CB, Lee NA, Jarnagin WR et al (2007) CT angiography for delineation of celiac and superior mesenteric artery variants in patients undergoing hepatobiliary and pancreatic surgery. Am J Roentgenol 189:W13–W19CrossRef Winston CB, Lee NA, Jarnagin WR et al (2007) CT angiography for delineation of celiac and superior mesenteric artery variants in patients undergoing hepatobiliary and pancreatic surgery. Am J Roentgenol 189:W13–W19CrossRef
Metadata
Title
Right hepatic artery from splenic artery: the four-leaf clover of hepatic surgery
Authors
Francesco Caruso
Daniele Dondossola
Gianluca Fornoni
Lucio Caccamo
Giorgio Rossi
Publication date
01-09-2016
Publisher
Springer Paris
Published in
Surgical and Radiologic Anatomy / Issue 7/2016
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-016-1617-x

Other articles of this Issue 7/2016

Surgical and Radiologic Anatomy 7/2016 Go to the issue