Surgical implications of anatomical variations in hepatic arteries

Abstract

Modal arterial vascularization of the liver is ensured by the common hepatic artery, branch of the celiac trunk. Anatomical variations are explained by the persistence or regression of primitive segmental arterial branches in the embryo. The aim of our work is to review the anatomy of the HA and the surgical implications arising from its variations, through a few observations. These variations have an impact primarily on hepatobiliary and pancreatic surgery, liver transplantation, as well while performing gastrectomy or interventional radiology procedures. Ignorance of these variants can lead to errors in surgical technique, often resulting in serious complications, dominated by intraoperative hemorrhage and ischemia or postoperative biliodigestive anastomosis leakage and biliary necrosis. Preoperative arterial CT-scan is the method of choice for mapping hepatic arterial anatomy and its variations.