Variations in origin and branching pattern of hepatic arteries and their clinical significance

Hepatobiliary surgeries require extensive knowledge of variations in the origin and branching pattern of arteries extending from the coeliac trunk till the cystic artery. This study was aimed at documenting all possible variations observed in the hepatic arterial tree by meticulous dissection of livers in formalin-fixed cadavers. Twenty formalin-fixed cadavers were meticulously dissected to study the hepatic arterial variations. The common hepatic artery originated from the coeliac trunk, common hepatogastric trunk and common hepatosplenic trunk in 85%, 5%, and 5% respectively. It was absent in 5%. It gave rise to the gastroduodenal and proper hepatic arteries in 85%, trifurcated into gastroduodenal, left and right hepatic arteries in 5%, and left hepatic, right hepatic and cystic arteries in 5%. The proper hepatic artery continued from the common hepatic artery in 85%, and was absent in 15%. It bifurcated into left and right hepatic arteries in 45%, showed a trifurcating pattern in 20% cases, gave rise to 3 separate hepatic branches in 5%, and continued as left hepatic artery alone in 15%. The left hepatic artery originated either from the proper hepatic artery or was a direct continuation of it in 85%, from the common hepatic artery in 10%, and the superior mesenteric artery in 5% cases. It gave rise to the cystic artery in 5%. The right hepatic artery originated from proper hepatic artery in 70%, abdominal aorta in 5%, coeliac trunk in 10%, superior mesenteric artery in 5%, common hepatic artery trifurcation in 10%, and gave rise to the cystic artery in 80%. The cystic artery was absent in 5%. Some of the findings have been reported in other studies, while some were newly reported in the present study. Knowledge of hepatic arterial variations is necessary to prevent complications involving several specialties including interventional radiology, endovascular surgery, chemotherapeutic procedures, hepatobiliary surgery as well as living donor liver transplantation surgeries.