University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
Am J Case Rep. 2022 Jun 15;23:e936546. doi: 10.12659/AJCR.936546.
BACKGROUND Pancreaticoduodenectomy, liver transplantation, cholecystectomy, and surgical management of traumatic injuries are all dependent on in-depth knowledge of the anatomy of the common hepatic artery and its subsequent divisions. The common hepatic artery arises from the celiac trunk, which is the first major branch of the abdominal aorta. The common hepatic artery bifurcates into the gastroduodenal artery traveling inferiorly behind the duodenal bulb and the proper hepatic artery continues laterally toward the liver within the hepatoduodenal ligament. The proper hepatic artery provides the right gastric artery before dividing into the left and right hepatic arteries. Anatomical variations in the common hepatic artery and its subdivisions are common and this case report identifies a seemingly undocumented novel variation. CASE REPORT 80-year-old female donor who died of lung adenocarcinoma presented with an anatomical variation of the common hepatic artery discovered during necroscopy. The donor had a common hepatic artery that gave rise to the left hepatic artery, then continued until it bifurcated into the gastroduodenal artery and right hepatic artery. The cystic artery originated from the left hepatic artery, traveling anteriorly over the bile duct and portal vein. The donor seems to have no proper hepatic artery and instead had a novel variation of the common hepatic artery. CONCLUSIONS The observation of this variation underscores the importance of not only being familiar with the standard anatomy but also for variations that can occur. It also furthers support of the standard of preoperative imaging for surgical patients to help identify and prepare for variations.
胰十二指肠切除术、肝移植、胆囊切除术以及外伤性损伤的外科治疗都依赖于对肝总动脉及其后续分支的深入了解。肝总动脉起源于腹腔干，这是腹主动脉的第一个主要分支。肝总动脉在十二指肠球部下方向后分叉为胃十二指肠动脉，而固有动脉在肝十二指肠韧带内向外侧继续向肝脏延伸。固有动脉在分为左、右肝动脉之前供应胃右动脉。肝总动脉及其分支的解剖变异很常见，本病例报告确定了一种似乎尚未记录的新变异。病例报告：一名 80 岁女性供体，死于肺腺癌，在尸检中发现肝总动脉的解剖变异。供体的肝总动脉发出左肝动脉，然后继续分支为胃十二指肠动脉和右肝动脉。胆囊动脉起源于左肝动脉，在胆管和门静脉前方走行。供体似乎没有固有动脉，而是有一个肝总动脉的新变异。结论：观察到这种变异突出了不仅要熟悉标准解剖结构，还要熟悉可能出现的变异的重要性。它还进一步支持对手术患者进行术前影像学检查的标准，以帮助识别和准备变异。
