Hepatic Artery System

Abstract

The source of hepatic arteries is determined before they enter the hepatoduodenal ligament. The arteries to the liver originate from three main sources: the celiac trunk, the left gastric artery and the superior mesenteric artery. Their embryological origin thus explains the relatively frequent presence of a left hepatic artery (dominant or accessory) stemming from the left gastric artery, as well as the “replacing” right hepatic artery and the “accessory” right hepatic artery originating from the superior mesenteric artery. There have been cases described where the right hepatic artery originated from the superior mesenteric artery, the middle hepatic artery from the celiac trunk and the left hepatic artery from the left gastric artery. In such cases surgeons performing liver transplantation had to use the aortic patch folding technique (Carrel patch), excising a patch of aorta together with the origin of the celiac trunk and the mesenteric arteries to facilitate an efficient anastomosis in the graft recipient. The common hepatic artery classically stems from the celiac trunk. When it gives off a gastroduodenal artery and sometimes a right gastric artery it becomes the proper hepatic artery. Sometimes the common hepatic artery derives from the hepatomesenteric trunk as the only artery to the liver and it is then a replacing type artery.