Published: 2017-08-26

Variant anatomy of common hepatic artery and its branching pattern: a cadaveric study with clinical implication

Swati Thamke, Pooja Rani


Background: With the advent of new diagnostic, therapeutic and operative techniques within the abdominal cavity, a sound knowledge of the variant courses of the abdominal vessels become important for dealing clinicians, surgeons and interventional radiologists. Surgeons undertaking hepatobiliary and gastric surgery must be acquainted with the anatomy of common hepatic artery and should be able to recognize its multiple anatomical variants to avoid subsequent thrombosis leading to ischaemia of the liver or bile duct and stomach with distressing consequences. The present study was carried out to document the normal anatomy and different variations of the common hepatic artery and to evaluate the possible clinical implications.

Methods: A total of 36 properly embalmed and formalin fixed cadavers were dissected in the abdominal region and viscera were mobilized to expose the origin of important branches of the common hepatic artery.

Results: Classical branching pattern of common hepatic artery was seen in 91.66% cases. Origin of right hepatic artery from superior mesenteric artery and accessory cystic artery from gastroduodenal artery was seen in 2.77% cases. In 5.55% cases, right gastric artery originated from left hepatic artery.

Conclusions: Knowledge of such variations will play a significant role in avoiding technical difficulties during infusion therapy and chemoembolization of neoplasm in the liver. It is also valuable in carrying out surgical intervention safely in the abdomen and also in the interpretation of angiographic reports.


Accessory cystic artery, Common hepatic artery, Right gastric artery, Superior mesenteric artery

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Nayak SB, Ashwini LS, Ravindra SS, Abhinitha P, Marpalli S, Patilet J. Surgically important accessory hepatic artery: a case report. J Morphol Sci. 2012;29(3):187-8.

Nayak SB. Hepatomesenteric trunk and gastro-splenico-phrenic trunk. Int J Anatomical Variations. 2008;1:2-3.

Romanes GJ. The abdominal cavity. In: Romanes GJ, eds. Cunningham’s manual of practical anatomy. 15th ed. Oxford, Oxford Medical Publication; 1986:91-127.

Hiatt JR, Gabbay J, Busuttil RW. Surgical anatomy of the hepatic arteries in 1000 cases. Ann Surg. 1994;220:50-2.

Moon JJ, Coen WA, James WM. Right hepatic artery branching off the superior mesenteric artery and its potential implications. Int J Anatomical Variations. 2009;2:143-5.

PerezSaborido B, Pacheco-Sánchez D, Barrera Rebollo A, Fuentes PP, Díaz AE, Rodriguez LF. Incidence of hepatic artery variations in liver transplantation: does it really influence short- and long-term results?. Transplant Proceeding. 2012;44(9):2606-8.

Yuksel M, Sargon M. A variation of a coeliac trunk. Okajimas Folia Anatomica Japonica 1992;69:173-5.

Mugunthan N, Jansirani DD, Felicia C, Anbalagan J. Anatomical variations in the arterial supply of liver. Int J Anatomical Variations. 2012;5:107-9.

Moore KL, Persaud TVN. The developing human (clinically oriented embryology). 7th ed. Philadelphia, Saunder; 2003:335.

Loukas M, Fergurson A, Louis Junior RG, Colborn GL. Multiple variations of the hepatobiliary vasculature including double cystic arteries, accessory left hepatic artery and hepatosplenic trunk: a case report. Surg Radiologic Anatomy. 2006;28(5):525-8.

Patil SJ, Rana K, Kakar S, Mittal AK. Unique origin of cystic artery from celiac trunk and its importance in laparoscopic cholecystectomy. J Morphol Sci 2013;30(3):200-2.

Williams PL, Warwick R, Dyson M, Bannister LH. Gray's Anatomy. Edinburgh, Churchill Livingstone; 1989:768-72.

Price P, Holden C. Anatomic variance in the cholecystic blood supply: a case report. Am Surg 199;59(5):278-80.

Bhagath VG, Potu K, Vasavi, Gorantla R, Thejodhar P. Anomalous origin of cystic artery from gastroduodenal artery: a case report. Int J Morphol. 2008;26(1):75-6.

Law SY Fok. edited by Josef E, Fischer, Kirby I, Bland Mark P, Callery Josef. Mastery of surgery. Part VII: the gastrointestinal tract; 1997;1:770.

Wood WC, Moore S, Staley C, Skandalakis JE. Anatomic basis of tumor surgery. Chapter 6: stomach and abdominal wall; 2nd edition. Springer- Verlag Berlin Heidelberg; 2010:308.

Barakate MS, Cappe I, Curtin A, Engel KD, Li-Kim-Moy J, Poon MS, Sandeman. Management of acute superior mesenteric artery occlusion. A NZ J Surg. 2002;72:25-9.

Losanoff JE, Millis JM, Harland RC, Testa G. Hepato-spleno-mesenteric trunk. J Am Coll Surg. 2007;204:511.