Malviya Kapil Kumar, Verma Ashish
Department of Anatomy, Institute of Medical Science, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India.
Department of Radiodiagnosis and Imaging, Institute of Medical Science, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India.
Diagnostics (Basel). 2023 Mar 24;13(7):1233. doi: 10.3390/diagnostics13071233.
Knowledge of anatomical variations of the hepatic artery from its origin to intrahepatic segmentation is of utmost importance for planning upper abdominal surgeries including liver transplantation, pancreatoduodenectomy, and biliary reconstruction. The origin and branching pattern of the hepatic artery was thoroughly described by the classification of Michels and Hiatt. Some rare variations of the hepatic artery were classified by Kobayashi and Koops. By the use of the multidetector computed tomography (MDCT) technique, the branching pattern of the hepatic artery can be visualized quite accurately. Unawareness of these arterial variations may lead to intraoperative injuries such as necrosis, abscess, and failure of the liver and pancreas. The origin and course of the aberrant hepatic arteries are crucial in the surgical planning of carcinoma of the head of the pancreas and hepatobiliary surgeries. In liver transplant surgeries, to minimize intraoperative bleeding complications and postoperative thrombosis, exact anatomy of the branching of the hepatic artery, its variations and intrahepatic course is of utmost importance. This review discusses variations in the anatomy of the hepatic artery from its origin to branching by the use of advanced imaging techniques and its effect on the liver, pancreatic, biliary and gastric surgeries.
了解肝动脉从起源到肝内分段的解剖变异对于规划包括肝移植、胰十二指肠切除术和胆道重建在内的上腹部手术至关重要。Michels和Hiatt的分类对肝动脉的起源和分支模式进行了详尽描述。Kobayashi和Koops对一些罕见的肝动脉变异进行了分类。通过使用多排螺旋计算机断层扫描（MDCT）技术，可以相当准确地显示肝动脉的分支模式。对这些动脉变异缺乏认识可能导致术中损伤，如坏死、脓肿以及肝脏和胰腺功能衰竭。异常肝动脉的起源和走行在胰头癌和肝胆手术的手术规划中至关重要。在肝移植手术中，为了尽量减少术中出血并发症和术后血栓形成，肝动脉分支的精确解剖结构、其变异以及肝内走行至关重要。本综述通过使用先进成像技术讨论肝动脉从起源到分支的解剖变异及其对肝脏、胰腺、胆道和胃部手术的影响。
