Department of Surgical Sciences, University of Perugia, Piazza dell'Università 1, 06100, Perugia, Italy.
Department of Surgical Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.
Surgeon. 2019 Jun;17(3):172-185. doi: 10.1016/j.surge.2019.03.001. Epub 2019 Apr 1.
The common hepatic artery (CHA) is the main arterial supply to the liver. Common classifications of the anatomical variations of the celiac trunk have only marginally described the CHA. Currently, the only classification addressing anatomical variants in cases of CHA absence from the celiac trunk is that reported by Huang et al. In this systematic review, the prevalence of these variations, according to Huang's classification, have been analyzed.
The review was registered in PROSPERO (CRD 42018096679). The risk of bias was assessed using the AQUA tool.
Fifty-four articles were included in the review (26,250 participants). The overall pooled prevalence estimate (PPE) of an absent CHA was 3.1%. Of those participants who underwent preoperative radiological evaluation, the overall PPE of an absent CHA was 3.8% for subjects who were evaluated via angiography and 3.0% for participants who underwent angio-CT evaluation. The overall PPE of an absent CHA was 3.9% in cadavers and 3.2% in participants evaluated surgically. Type I or Type II aberrations were the most common; in participants with CHA aberrations, 65.4% of those participants had either Type I or Type II aberrations.
The overall PPE of an absent CHA was 3.1%, a result representing a significant, common anatomical variation. Our study revealed that an absence of a CHA was associated with a replaced CHA. The most common arterial variant was a replaced CHA originating from the Superior Mesenteric Artery and running across the anterior or posterior side of the pancreas (i.e., Types I and II).
肝总动脉（CHA）是肝脏的主要动脉供应源。对腹腔干解剖变异的常见分类仅略微描述了 CHA。目前，唯一针对腹腔干内 CHA 缺失的解剖变异分类是 Huang 等人报告的分类。在本系统评价中，根据 Huang 的分类分析了这些变异的流行率。
该综述在 PROSPERO（CRD42018096679）中进行了登记。使用 AQUA 工具评估偏倚风险。
本综述共纳入 54 篇文章（26250 名参与者）。无 CHA 的总体合并流行率估计（PPE）为 3.1%。在接受术前影像学评估的参与者中，通过血管造影评估的无 CHA 的总体 PPE 为 3.8%，通过血管 CT 评估的参与者为 3.0%。在尸体中无 CHA 的总体 PPE 为 3.9%，手术评估中为 3.2%。I 型或 II 型异常是最常见的；在 CHA 异常的参与者中，65.4%的参与者存在 I 型或 II 型异常。
无 CHA 的总体 PPE 为 3.1%，这是一种常见的显著解剖变异。我们的研究表明，无 CHA 与替代 CHA 有关。最常见的动脉变异是起源于肠系膜上动脉并穿过胰腺前侧或后侧（即 I 型和 II 型）的替代 CHA。
