Aberrant left hepatic artery in laparoscopic antireflux procedures

Abstract

ALHA is not an uncommon finding in laparoscopic antireflux surgery and may be found in > or =8% of patients. Division may be required due to impaired view of the operating field or bleeding. Patients do not experience clinical complaints after division, but liver enzymes may be temporarily elevated.

Anatomic variations of the hepatic arteries in 250 patients studied with 64-row CT angiography

“…These vessels may be accessory, occurring in addition to the normal arterial supply, or replaced, representing the primary arterial supply to the lobe. Moreover, aberrant hepatic arteries can be of major surgical significance in operations of the upper intestinal tract, the liver, and the gallbladder and pancreas, especially for laparoscopic procedures [4][5][6][7][8]; they can also become a technical problem for infusion therapy and transarterial chemoembolization of neoplasms [9,10]. In Michels' classic autopsy series of 200 dissections [11], published in 1966, the basic anatomical variations in hepatic arterial supply were defined and this classification has served as the benchmark for all subsequent contributions in this area.…”

Left Accessory Hepatic Artery Damage by a Misplaced Gastric Band in a Deceased Liver Donor

“…Postoperatively, only 2 (11.7%) patients had transient elevated liver enzymes. At a mean follow-up of 28.5T12.8 months, no specific complaints could be identified (6). In our case, before ligating the artery, we first checked if this artery was an accessory and not a replaced artery; second, we visualized back-bleeding into this artery after reperfusion, which may represent a sign of collateral/redundant arterial supply.…”

Unique Conglomeration of Arterial Variations in the Upper Abdomen: CT Angiographic Study

“…The aberrant left hepatic artery (ALHA) coursed through the gastrohepatic ligament to reach the left lobe of the liver. The importance and significance of an ALHA is greatest for liver transplantation and operations performed near the gastrohepatic ligament, including esophago-gastrectomy, gastrectomy, gastric bypass, and anti-reflux procedures [10,11].…”