Variations in the Origin and Course of Right Hepatic Artery and its Surgical Significance

Mugunthan, N; Kannan, R. Jagadeesh; Jebakani, Christilda Felicia; Anbalagan, J

doi:10.7860/jcdr/2016/22126.8428

Cited by 22 publications

(24 citation statements)

References 6 publications

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“…Normal hepatic arterial anatomy is present in 51%-76% of the general population, [17][18][19] while the incidence of the anterior course of the RHA in the normal population ranges from 1.4%-10%. 2,20,21 In the current study, patients with CBD had a significantly higher incidence of the anterior type of RHA (33%) than patients without CBD (9%), although the origin of the RHA did not significantly differ between these two groups. Lal et al 10 reported that the RHA crossed anterior to the CHD in 15 of 117 (13%) patients.…”

Section: Discussioncontrasting

confidence: 54%

Congenital biliary dilatation in the era of laparoscopic surgery, focusing on the high incidence of anatomical variations of the right hepatic artery

Mori

Nakata

Aly

et al. 2020

J Hepato Biliary Pancreat

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Vascular and ductal anomalies of the hepatobiliary system are common, and many studies have addressed the anatomical variations of the arteries and ducts of the biliary system. 1-3 Preoperative study of the hepatobiliary anatomy with recognition of possible anatomical variations allows safe hepatic resection without vascular injuries or postoperative complications. Mishaps during hepatobiliary-pancreatic surgery commonly involve the right hepatic artery (RHA). Anatomical variations of the RHA lead to serious intra-and postoperative complications such as bleeding, ischemia, stenosis of the biliary anastomosis, liver abscess formation, and hepatic infarction, even in surgery performed by experienced

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Section: Discussioncontrasting

confidence: 54%

Congenital biliary dilatation in the era of laparoscopic surgery, focusing on the high incidence of anatomical variations of the right hepatic artery

Mori

Nakata

Aly

et al. 2020

J Hepato Biliary Pancreat

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“…[ 2 ] The normal RHA arises from the PHA, whereas an RRHA arises from other sources. [ 11 ] ARHA and RRHA are well described in the literature by Michels, [ 16 ] Suzuki et al, [ 18 ] Mäkisalo et al, [ 19 ] Hiatt et al, [ 17 ] Gruttadauria et al, [ 9 ] Covey et al, [ 8 ] Varotti et al, [ 20 ] Kishi et al, [ 21 ] Koops et al, [ 22 ] Ahn et al, [ 6 ] Abdullah et al, [ 23 ] López-Andújar et al, [ 24 ] Winston et al, [ 25 ] De Cecco et al, [ 26 ] Egorov et al, [ 27 ] Saba and Mallarini, [ 28 ] Gümüs et al, [ 29 ] Loschner et al, [ 10 ] Dandekar et al, [ 15 ] Mugunthan et al, [ 11 ] Thangarajah and Parthasarathy, [ 30 ] as well as some case reports (Tables 1 and 2 ). [ 3 – 39 ] By systematic review of these articles and case reports, we identified the various origins of ARHA and RRHA, as well as their incidence.…”

Section: Discussionmentioning

confidence: 99%

“…[ 10 ] The accepted “normal” RHA arises from the PHA, whereas RRHA arises from a different source. [ 11 ] The RRHA can arise from LGA, GDA, CHA, [ 9 ] SA, [ 12 ] RA, inferior mesenteric artery (IMA), [ 11 ] SMA, [ 13 ] CT, [ 14 ] right phrenic artery (RPA), [ 8 ] or directly from the AA. [ 15 ] However, these 2 variant arteries always occur independently in humans.…”

Section: Introductionmentioning

confidence: 99%

Rare anatomic variation of the right hepatic artery and accessory right hepatic artery supplying hepatocellular carcinoma

Liang

Li²,

Min³

et al. 2017

Medicine

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Introduction:Each hepatic artery is functionally essential for providing blood supply to the liver, and so are variant arteries. Variant arteries, including the accessory right hepatic artery (ARHA) and replaced right hepatic artery (RRHA) are commonly described in the literature. However, they usually occur independently. Here, we report an extremely rare case that involved both an ARHA and an RRHA arising from the gastroduodenal artery (GDA) and superior mesenteric artery (SMA), respectively. To date, this situation has never been reported in the literature.They were preoperatively identified during magnetic resonance imaging (MRI) examination in a 69-year-old male patient with hepatocellular carcinoma. And they were further verified by following conventional angiography for transcatheter arterial chemoembolization (TACE) for the patient. In addition, the patient's tumor was primarily supplied by these 2 variant arteries. After the successful TACE procedure, the patient had a well postoperative recovery.Conclusions:By analyzing this case and performing a systematic review of the literature, the important clinical implications of the ARHA and RRHA will be investigated and discussed. Main lessons learned from this case thorough understanding of the normal anatomy of the hepatic artery and its anatomic variation is crucial for surgeons and interventional radiologists; preoperative computed tomography, MRI, and intraoperative angiography play an important role in detecting the variant hepatic artery; identifying these anomalous hepatic arteries before operation can effectively avoid unintentional injury during surgery, such as massive hemorrhage or hepatic infarction.

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“…However, the importance of recognising these variances is no longer limited to invasive surgical procedures, as in our case of a pancreaticoduodenectomy. Newer techniques to approaching hepatic tumours including transhepatic arterial chemoembolisation (TACE) and hepatic arterial perfusion scintigraphy are of increasing popularity 4. Therefore, it is important to interventional radiologists and surgeons alike to be aware of rare anomalies in this region.…”

Section: Discussionmentioning

confidence: 99%

Replaced right and left hepatic arteries: a variation in origin and course

Asif¹,

Anewenah

Reddy

et al. 2017

BMJ Case Reports

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In ∼60% of cases, hepatic artery anatomy is of the normal variant. However, in 40% of cases, anomalies can exist. Preserving the hepatic blood supply is paramount in hepatobiliary procedures. We report an aberrant right hepatic artery coursing retroportally, with an aberrant left hepatic artery originating directly from the coeliac artery in a patient who underwent an elective pancreaticoduodenectomy (Whipple procedure).

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Variations in the Origin and Course of Right Hepatic Artery and its Surgical Significance

Cited by 22 publications

References 6 publications

Congenital biliary dilatation in the era of laparoscopic surgery, focusing on the high incidence of anatomical variations of the right hepatic artery

Congenital biliary dilatation in the era of laparoscopic surgery, focusing on the high incidence of anatomical variations of the right hepatic artery

Rare anatomic variation of the right hepatic artery and accessory right hepatic artery supplying hepatocellular carcinoma

Replaced right and left hepatic arteries: a variation in origin and course

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