• Kosin Medical Journal
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• v.33 no.3
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• pp.463-467
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• 2018

The hepatic artery can have numerous variations. However, a common hepatic artery originating from the left gastric artery and the entire hepatic blood supply furnished by the left gastric artery is an extremely rare anomaly. We encountered this anomaly in a patient with advanced gastric cancer. A surgeon should recognize this image appearance and identify the anomaly. Without knowledge of this anomaly and given the strategy for extensive lesser sac dissection generally employed during gastric cancer surgery, a surgeon could easily inadvertently divide this vessel, resulting in critical liver damage. We report a case of common hepatic artery originating from left gastric artery and review of the literatures.

• Journal of International Society for Simulation Surgery
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• v.1 no.2
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• pp.87-89
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• 2014

An aberrant left hepatic artery is one of the most common variants of hepatic arteries, and its prevalence has been reported 6.5-30%. During D2 lymph node dissection for gastric cancer, an aberrant left hepatic artery arising from left gastric artery is ligated which may lead to hepatic damage. In this case report, a 66-year-old male patient underwent total gastrectomy with D2 lymph node dissection during which the aberrant left hepatic artery was ligated. Post-operative liver function tests revealed elevated liver enzymes, and ischemic changes in the left lateral hepatic section was seen on the CT scan. On retrospective review of preoperative CT images, a replaced left hepatic artery from left gastric artery could have been identified. The information on the presence of aberrant LHA and its supplying area is clinically important when planning curative gastrectomy for gastric cancer, because extended lymph node dissection requires division of the left gastric artery and this may lead to severe liver damage. By using preoperative CT scan, detection of aberrant left hepatic artery could be done.

• Journal of Trauma and Injury
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• v.19 no.2
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• pp.196-200
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• 2006

We report a case of celiac artery dissection after abdominal blunt trauma. A 29-year-old man visited the emergency room for acute left periumbilical pain after abdominal blunt trauma from his child. Computed tomography showed a wedge-shaped splenic infarction with splenic artery thrombus. He was hospitalized for careful observation, and after two days, follow-up computed tomographic angiography showed a progressed celiac artery dissection that involved common hepatic artery and an increased extent of splenic infarction. He underwent conventional angiography, and a self-expandable stent was placed between the celiac axis and the common hepatic artery. After two days, follow-up computed tomographic angiography showed good hepatic arterial blood flow via the stent and no progression of splenic infarction. After ten days, he was discharged without complications.

• Anatomy and Cell Biology
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• v.56 no.2
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• pp.276-279
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• 2023

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.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.33-37
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• 2009

Purpose: Liver transplantation is considered as the treatment of choice in many acute and chronic liver diseases, and it is becoming more common. Since successful microscopic anastomosis of hepatic artery is a crucial requirement of successful liver transplantation, we studied and analyzed the result of hepatic artery anastomosis of liver transplantation in our liver transplantation center. Methods: 145 liver transplantations were performed between February 2005 and May 2008. Male to female ratio of the liver transplantation recipients was 3.4 : 1. Anastomosis of portal vein, hepatic vein and biliary tract was performed by the general surgeon, and anastomosis of hepatic artery was performed by the plastic surgeon under the loupe or microscopic vision. After the hepatic artery was reconstructed, anastomosed site status and flow were checked with Doppler ultrasonography intraoperatively and with contrast enhanced CT or angiography postoperatively if necessary. Results: Out of 145 liver transplantations, cadaveric liver donor was used 37 cases and living donor liver transplantation was performed 108 cases including the 2 dual donor liver transplantations. As for the baseline diseases that resulted in the liver transplantation, there were 57 cases of liver cirrhosis and hepatocellular carcinoma due to hepatitis B, taking up the greatest proportion. Single donor hepatic artery was used in 114 cases, and mean artery diameter was 2.92 mm and mean artery length was 24.25 mm. Hepatic artery was used as the recipient artery in every case except the 8 cases in which gastroepiploic artery was used as alternative. Out of 145 cases of hepatic artery anastomosis, 3 cases resulted in the thrombosis of the hepatic artery, requiring thrombectomy and re - anastomosis. In all 3 cases, thrombosis was found in left hepatic artery and there was no past history of hepatic artery chemoembolization. Conclusion: Incidence of hepatic artery thrombosis after the anastomosis of hepatic artery during liver transplantation was 2.1%, which is considered sufficiently low.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.189-193
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• 2022

Hemorrhage after pancreaticobiliary surgery is an infrequent but fatal complication. It is primarily caused by rupture of the pseudoaneurysm, and treatment options include endovascular coil embolization or endovascular stent-graft placement. Herein, we report a case of migration of an arterial stent-graft that was placed in the common hepatic artery to treat pseudoaneurysm after pylorus-preserving pancreaticoduodenectomy. The stent-graft migrated to the jejunum and was eventually excreted from the body.

• Korean Journal of Veterinary Research
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• v.59 no.2
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• pp.55-58
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• 2019

This study was performed to examine the visualization and anatomical variants of the hepatic artery with dual-phase computed tomography (CT) angiography and three-dimensional volume rendering imaging analysis in clinically normal dogs. Seven healthy beagle dogs were enrolled and underwent dual CT angiography. Arterial phase images could be obtained with multi-detector CT angiography using the fixed-scan method in these dogs. Contrast enhancement of the hepatic parenchyma was quite minimal because of the unique blood supply system of the liver. In most dogs, the main hepatic arterial branches were the right lateral branch, left branch, and right medial branch. Although hepatic arterial variation appears to be common in dogs, only one dog in this study had the caudate lobar branch as the first branch of the hepatic artery. Further study on a larger number of dogs with CT images will be needed to identify and classify the pattern of hepatic arterial variations.

• Journal of Trauma and Injury
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• v.29 no.2
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• pp.47-50
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• 2016

Transcatheter arterial embolization (TAE) for blunt hepatic injury in children is not common and is especially rare after damage control surgery (DCS). We report a successful TAE after DCS on a child for massive bleeding from the left hepatic artery due to a motor vehicle accident. The car (a sport utility vehicle) ran over the chest and abdomen of a 4-year-old boy. On arrival, initial vital signs were as follows: blood pressure, 70/40 mmHg; heart rate, 149/min; temperature, $36.7^{\circ}C$; respiratory rate, 38/min. After resuscitation, computed tomography was done, and a suspicious contrast leakage from a branch of the left hepatic artery and a spleen injury (grade V) were found. TAE was performed successfully after DCS for a liver injury.

• Korean Journal of Veterinary Research
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• v.32 no.4
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• pp.511-521
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• 1992

The distribution of the hepatic arteries within the liver in 30 Korean native cattle were observed. Vinylite solution was injected into the hepatic arteries of 10 livers for cast preparation. The angiography was prepared in 20 livers by injected 30% barium sulfate solution into the hepatic arteries and then radiographed on X-ray apparatus. The results were summarized as follow ; 1. The hepatic arteries were divided into the Ramus (R.) sinister, R. dexter and R. intermedius. The intrahepatic arteries were derived from the R. sinister and R. dexter. The R. intermedius divided into the Arteria(A.) gastrica dextra, A. gastroduodenalis and A. cystica. 2. The right branch (ramus dexter) of the hepatic artery supplies the right lobe and caudate process. It consisted of the A. dorsalis lobi dextri, A. ventralis lobi dextri and A. lobi caudati. They formed one common trunk with three arteries(6 cases, 20%), and two arteries formed common trunk with the A. ventralis lobi dextri and A. lobi caudati (16 cases, 52.8%), or with A. dorsalis lobi dextri and A. lobi caudati (5 cases, 16.5%). The three arteries arose from the A. hepatia independently(3 cases, 10%). 3. The left branch (ramus sinister), larger than the right and often double (6 cases, 20%), supplies the caudate, quadrate and left lobes, and often gives origin to the A. gastrica dextra. 4. The branches of hepatic artery in the left lobe were derived from A. dorsalis lobi sinistri, A. ventralis lobi sinistri and A. intermedius lobi sinistri. The A. intermedius lobi sinistri were absent in some cases (3 cases, 10%). They almostly originated a single branch and often two branches. 5. The A. cystica arose from the R. intermedius(27 cases, 90%) and A. hepaica(3 cases, 10%). 6. The Rami processus papillarum arose from dorsal border of the Pars transversa of the left branch(19 cases, 62.7%), the left branch and right branch (9 cases, 30%) or A. hepatica(2 cases, 6.6%). 7. The A. lobi quadrata arose from either the Pars transversa of left branch (12 cases, 40%) or A. hepatica(4 cases, 13.2%). It also arose from both Pars transversa of left branch and A. ventralis lobi sinistri (3 cases, 10%). 8. The anastomosis on the branches of A. hepatica was observed in intrahepatic and cystic arteries. The left and right branches ramified several secondary radiating branches within the liver. 9. The hepatic arteries formed a very short common trunk of the right branch ($18.75{\pm}11.89$ : 2.20~44.8mm) and a long Pars transversa of the left branch($72.85{\pm}20.04$ : 28.2~104.1mm). 10. The ramified angles at the A. dorsalis lobi dextri, A. ventralis lobi dextri, A. lobi sinistri, A. ventralis lobi sinistri, A. lobi quadrata, A. cystica and Rami processus papillarum were 50-80, 270-300, 340-20, 120-160, 160-290, 200-230, 250~290, 230~280 and 80~120 degrees, respectively.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.325-329
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• 1989

A rare case of aneurysm of the celiac artery due to arteriosclerosis was presented. The patient was 56-year-old female and had suffered from hypertension for 4 years, and recently, from dyspepsia prior to admission for 2 months. The operation was operated upon by interposition of an autogenous tubular saphenous vein graft between the proximal celiac artery and the common opening of the hepatic and the splenic arteries in the opened aneurysmal sac with inclusion technique. The postoperative course was uneventful.