Common hepatic artery quadrifurcation associated with right hepatic artery from superior mesenteric artery during laparoscopic total splenopancreasectomy


COD: 04_2017_15_2724 Categorie: ,

Francesco Caruso, Giorgio Alessandri, Francesca Ciccarese, Giovanni Cesana, Matteo Uccelli, Giorgio Castello, Roberta Villa, Stefano Olmi

Ann Ital Chir, 2016 88, 4: 365-367
Epub Ahead of Print – June 12

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Hepatobiliopancreatic surgery is challenging becouse of the complexity of resections and reconstructions and variability of
vascular anatomy. The arterial vascularization of the liver is susteined by the common hepatic artery (CHA) that originates
from the celiac trunk (CT). The CHA bifurcates into the gastroduodenal artery (GDA) and proper hepatic artery
(PHA) 0.5-1 cm medial to the common bile duct (CBD), and the PHA bifurcates into a right and a left branch at
hepatic hilum. The most frequent variants are the right hepatic artery (RHA) from the superior mesenteric artery (SMA),
the left hepatic artery (LHA) from the left gastric artery (LGA) or a combination of these two variants. Herein, we
describe the case of a 70 years old woman affected by IPMN of the pancreas with a quadrifurcation of CHA, associated
with a RHA off the SMA.