Surgery>>>>>Liver
Question 2#

The most common variant of normal hepatic artery anatomy is:

A) Replaced left hepatic artery from the left gastric artery
B) Completely replaced common hepatic artery from the superior mesenteric artery (SMA)
C) Replaced right and left hepatic arteries
D) Replaced right hepatic artery from the SMA

Correct Answer is D

Comment:

Understanding the anatomic variants of the hepatic arterial supply is important to avoid complications during liver surgery. The standard arterial anatomy is as follows: the common hepatic artery arises from the celiac trunk, and then divides into the gastroduodenal and proper hepatic artery. In a standard configuration, the proper hepatic artery gives rise to the right gastric artery, but this is variable. The proper hepatic artery then divides into the right and left hepatic artery (Fig. below). However, this standard arterial configuration only occurs in 76% of patients. The most common variants include replaced right hepatic artery from the SMA (10-15%), replaced left hepatic artery from the left gastric artery (3- 10%), replaced right and left hepatic arteries (1-2%), and the completely replaced common hepatic artery from the SMA (1-2%) figure below.

Arterial anatomy of the upper abdomen and liver, including the celiac trunk and hepatic artery branches. a . = artery; LHA = left hepatic artery; RHA = right hepatic  rtery.

Common hepatic artery anatomic variants. SMA = superior mesenteric artery.