Replaced gastroduodenal artery with continuation as accessory left hepatic artery: a rare anatomical variant

Chen, Jesse; Ramjit, Amit; Ahmad, Noor Ani

doi:10.1186/s42155-018-0032-2

Cited by 6 publications

(3 citation statements)

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“…The literature describing iatrogenic hepatic artery injuries or complications relevant to aberrant hepatic arteries that did not fit Michels' classification was reviewed ( Table 5 ). Ignoring variants such as an rRHA arising from the GDA (CR rG L) might lead to intraoperative injury to the rRHA and result in hepatic ischaemia if the GDA is ligated during Whipple's procedure.…”

Section: Resultsmentioning

confidence: 99%

Hepatic artery classification based on three-dimensional CT

Yan

Feng

Wang

et al. 2020

British Journal of Surgery

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Background: Precise classification of the hepatic artery is helpful for preoperative surgical planning in hepatobiliary-pancreatic surgery. However, the anatomy of hepatic arteries is variable. This study investigated anatomical variation using three-dimensional visualization and evaluation (3DVE) to develop a nomenclature system. Methods: The origin and course of the hepatic artery were tracked and analysed by using three-dimensional visualization of CT images acquired between 2013 and 2017. The new classification and nomenclature system, named CRL, was developed based on the origins of the common, right and left hepatic arteries. Results: Scans from 770 adults were evaluated. Preoperative 3DVE correlated better with surgical findings than the original CT images alone. Using the CRL classification system, hepatic arteries were divided into nine subtypes. Only 87⋅4-89⋅2 per cent of the hepatic arteries of 610 living-donor liver transplant donors were depicted in Michels', Hiatt's or Varotti's classification, compared with 100 per cent identified by the CRL classification. The CRL classification was validated against external data sets from previous studies, with 99⋅6-100⋅0 per cent of patients classified by the CRL system. Conclusion: The CRL classification covers hepatic artery variants and may be used for planning liver surgery.

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Section: Resultsmentioning

confidence: 99%

Hepatic artery classification based on three-dimensional CT

Yan

Feng

Wang

et al. 2020

British Journal of Surgery

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“…In a meta-analysis of CA variations which included 12,000 cases from 36 studies, there was no mention of a replaced GDA (rGDA) [2,7]. Many other studies have identified frequency of variations in origin of rGDA, summarised in Table 1 [14][15][16][17][18][19][20][21][22][23][24][25][26]. The various sites of origin of rGDA are shown in Figure 1.…”

Section: Origin Of Gdamentioning

confidence: 99%

Gastroduodenal artery: single key for many locks

Desai

Pande

2019

J Hepato Biliary Pancreat

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Gastroduodenal artery (GDA) commonly arises from common hepatic artery, a branch of celiac axis. It holds a unique anatomical position that connects the foregut and midgut due to its intimate communications with foregut and midgut arterial supply. Its numerous anatomical variations have a significant impact on planning and performance of hepatopancreaticobiliary (HPB) surgery. Its close relation to the first part of duodenum, common bile duct and head of pancreas makes it susceptible for inadvertent bleeding during or after surgery, or due to various HPB pathologies. Also, a large number of vascular interventions rely on GDA and its branches. Careful preoperative planning is the key and a detailed knowledge and awareness of its variant anatomy is of paramount importance, be it liver resections, liver transplant, biliary and pancreatic resections and pancreatic transplant or transarterial procedures involving these arteries. GDA can also be a cause of gastrointestinal hemorrhage due to true or pseudoaneurysms and anatomy has significant implications on its management. The article provides a succinct review on relevance of GDA anatomy and variations and highlights that preoperative planning and intraoperative awareness of variations is the key to performance of safe HPB surgery and interventions.

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“…The SMA arises from the abdominal aorta, giving off five sets of branches: the inferior pancreaticoduodenal artery, the intestinal arteries, the ileocolic artery, the right colic artery, and the middle colic artery [ 7 ]. Previous case reports have also described other types of variation between the CHA and the SMA [ 14 – 16 ]. Kardile et al [ 14 ] indicated that the CHA was sometimes absent, with the right accessory hepatic artery arising from the SMA.…”

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confidence: 99%