Anatomy and Cell Biology

  • 제56권2호
  • /
  • Pages.276-279
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  • 2023
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  • 2093-3665(pISSN)
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  • 2093-3673(eISSN)
대한해부학회 (Korean Association of Anatomists)
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A portal quadrad with triple hepatic arteries

  • 투고 : 2022.12.03
  • 심사 : 2022.12.22
  • 발행 : 2023.06.30
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초록

The arterial support of the liver is most commonly from the celiac trunk via the proper hepatic artery (PHA). The PHA divides into left and right branches: the right hepatic artery (RHA) supplies the right and caudate lobes while the left hepatic artery (LHA) supplies the left and quadrate lobes. Aberrant hepatic arteries are relatively common, and the most frequent contributors are the superior mesenteric artery and left gastric artery. Herein we present findings from postmortem dissection of an abdominal cavity that revealed a rare combination of reported variations. Specifically, this subject had three extrahepatic arteries - a replaced LHA (rLHA), a PHA, and a replaced RHA (rRHA). The rLHA originated from the left gastric and the rRHA originated from the superior mesenteric artery. Knowledge of these variations is important for surgical and radiological procedures to avoid complications during treatment and improve patient outcomes.

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과제정보

The authors sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially increase mankind's overall knowledge that can then improve patient care.

참고문헌

  1. Standring S. Gray's anatomy: the anatomical basis of clinical practice. 40th ed. Edinburgh: Churchill Livingstone; 2008.
  2. Sahni D, Aggarwal A, Gupta T, Kaur H, Gupta R, Chawla K, Saini N, Garg S, Singla A, Deep A, Singh HJ, Shekhawat D, Rapotra M. Abdominal aorta. In: Tubbs RS, Shoja MM, Loukas M, editors. Bergman's Comprehensive Encyclopedia of Human Anatomic Variation. Hoboken: John Wiley & Sons; 2016. p.619-81.
  3. Noussios G, Dimitriou I, Chatzis I, Katsourakis A. The main anatomic variations of the hepatic artery and their importance in surgical practice: review of the literature. J Clin Med Res 2017;9:248-52. https://doi.org/10.14740/jocmr2902w
  4. Douard R, Chevallier JM, Delmas V, Cugnenc PH. Clinical interest of digestive arterial trunk anastomoses. Surg Radiol Anat 2006;28:219-27. https://doi.org/10.1007/s00276-006-0098-8
  5. Sahani D, Mehta A, Blake M, Prasad S, Harris G, Saini S. Preoperative hepatic vascular evaluation with CT and MR angiography: implications for surgery. Radiographics 2004;24:1367-80. https://doi.org/10.1148/rg.245035224
  6. Karakoyun R, Romano A, Yao M, Dlugosz R, Ericzon BG, Nowak G. Impact of hepatic artery variations and reconstructions on the outcome of orthotopic liver transplantation. World J Surg 2020;44:1954-65. https://doi.org/10.1007/s00268-020-05406-4
  7. Hemming AW, Finley RJ, Evans KG, Nelems B, Fradet G. Esophagogastrectomy and the variant left hepatic artery. Ann Thorac Surg 1992;54:166-8. https://doi.org/10.1016/0003-4975(92)91173-7
  8. Mahajan A, Tiwari S, Mishra S. A unique conglomeration of variations in the celiac, hepatic, and superior mesenteric artery: a clinico-embryological perspective. Int J Appl Basic Med Res 2018;8:256-8. https://doi.org/10.4103/ijabmr.IJABMR_395_17
  9. Jin GY, Yu HC, Lim HS, Moon JI, Lee JH, Chung JW, Cho BH. Anatomical variations of the origin of the segment 4 hepatic artery and their clinical implications. Liver Transpl 2008;14:1180-4. https://doi.org/10.1002/lt.21494
  10. Shankar S, Rammohan A, Rela M, Srinivasan P. Surgical anatomy of segment four of liver and its implications in hepato-biliary surgery and liver transplantation. J Liver Transpl 2022;6:100076.
  11. Flint ER. Abnormalities of the right hepatic, cystic, and gastroduodenal arteries, and of the bile-ducts. Br J Surg 1923;10:509-19. https://doi.org/10.1002/bjs.1800104011
  12. Bhargava GS, Singh H, Singh HD, Gupta R. Moynihan's hump of right hepatic artery: a case report and surgical significance. CIBTech J Surg 2014;3:42-4.
  13. El Amrani M, Pruvot FR, Truant S. Management of the right hepatic artery in pancreaticoduodenectomy: a systematic review. J Gastrointest Oncol 2016;7:298-305.
  14. Traverso LW, Freeny PC. Pancreaticoduodenectomy. The importance of preserving hepatic blood flow to prevent biliary fistula. Am Surg 1989;55:421-6.
  15. Aramaki O, Sugawara Y, Kokudo N, Takayama T, Makuuchi M. Branch patch reconstruction in living donor liver transplantation: arterialization of grafts with replaced type arteries. Transplantation 2006;82:1541-3. https://doi.org/10.1097/01.tp.0000236102.36326.a6