• 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.

• Korean Journal of Veterinary Research
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• v.39 no.3
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• pp.665-671
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• 1999

The aim of this study was to establish selective hepatic artery catheterization technique through percutaneous femoral artery puncture and to offer digital subtraction angiography (DSA) of hepatic artery in beagle dogs. Percutaneous femoral artery puncture was performed with Sheldinger's method. Microferret$^{TM}$-18 Infusion catheter(William, Cook, Europe) was introduced into abdominal aorta. Then, under fluoroscopy, iopamidol 370(Bracco, Italy) was injected to identify celiac artery and 'J' shaped guide wire was introduced into celiac artery. Catheter could be introduced into celiac artery through guide wire. In this manner, catheter was located at the insertion of hepatic artery and DSA was performed. In DSA of beagle dogs, hepatic artery which was divided into lateral branch, right-medial branch, right-lateral branch of hepatic artery, cystic artery and gastroduodenal artery was opacified without superimposition of any other body structure and so was the parenchyme of liver afterward. In autopsy angiographic finding of resected liver, cystic artery, caudate branch, lateral branch, right-medial branch, right-lateral branch and quadrate branch of hepatic artery were identified. It was concluded that selective hepatic artery catheterization technique was a minimally invasive method that facillitated the approach of hepatic artery and DSA was an excellent tool to visualize the vessle of liver in dogs.

• 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.

• 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.

• 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.

• Archives of Plastic Surgery
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• v.33 no.4
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• pp.454-457
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• 2006

Purpose: The anastomosis of hepatic artery to recipient vessel has a major role in a liver transplantation, so its occlusion is the most important cause of failure of liver transplantations. We made the study to reveal the peculiarities in pediatric liver transplantations compared with adult cases. Methods: From January 1999 to September 2005, we performed 99 cases of pediatric liver transplantation. The mean age at operation was 4.17 years of age. The hepatic vein and portal vein are anastomosed by the general surgeons and then the hepatic artery is anastomosed by the plastic surgeons. The Doppler ultrasonography and computed tomography were used for postoperative checkup for hepatic artery patency. Results: There were no immediate complications, but hepatic arterial occlusion was developed in 3 cases (2.8%). In pediatric patients, the anastomosis of hepatic artery is more difficult than adults because of the rapid respiratory and pulse rate, the small vascular diameter, and the large gap of diameter difference between the recipient and the donor vessels. Conclusion: We could confirm that pediatric liver transplantations are relatively safe but long learning curve was needed.

• 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.

• Journal of Yeungnam Medical Science
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• v.13 no.1
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• pp.146-151
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• 1996

Majority of hepatocellular carcinoma is evolved from a well differentiated cancerous condition such as hyperplastic lesions eg. adenomatous hyperplasia in cirrhotic liver or de no vo carcinogenesis and prolifenation along with dedifferentiation. Adenomatous hyperplasia is may be seen in severe acute hepatic injury, like submassive hepatic necrosis, or in chronic liver diseases, particularly liver cirrhosis and it has recently attracted much interest from both clinicians and pathologists because it is regarded as a precursor lesion of hepatocellular carcinoma. Hepatic adenomatous hyperplasia resembling focal nodular hyperplasia might have developed from localized vascular changes associated with chronic liver disease, pre-existing arterial malformation and early stage of angiogenesis in hepatocarcinogenesis. We present a patient who developed hepatocellular carcinoma after hepatic artery ligation.

• Journal of Yeungnam Medical Science
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• v.29 no.1
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• pp.24-27
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• 2012

Mycotic hepatic artery aneurysms (HAAs) have become very rare due to antibiotics. Untreated, they have a high possibility of rupture and mortality. In this paper, on the case of a 67-year-old male who had severe right-upper-quadrant abdominal pain and a history of infective endocarditis is reported. The computed tomography (CT) and arterial angiography findings led to a diagnosis of a ruptured mycotic HAA. The CT showed an HAA and the formation of an intrahepatic hematoma caused by aneurysmal rupture. The arterial angiography showed a mycotic HAA that arose from the right posterior hepatic artery. Percutaneous transcatheter arterial embolization was used to successfully treat the HAA. Since then, the patient has been doing well, without symptoms.

• 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.