Poster Board Number: 60
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Co-authors:
Ibrahim Nassour, M.D. - Assistant Professor, Surgery, University of Florida; Venkatesh Nonabur, M.D. - Assistant Scholar, Anatomy and Cell Biology, University of Florida; Ashley Walker - Ph.D. Candidate, Anatomy and Cell Biology, University of Florida
PhD Candidate University of Florida Gainesville, Florida, United States
Abstract Body : A rare anatomic variant involving the Right Hepatic artery arising directly from the Celiac Trunk (CT) is presented. Variations in CT branching or hepatic arterial anatomy are not particularly uncommon, and most involve the Left Gastric artery arising directly from the aorta or some involvement of the Superior Mesenteric artery. However, in this case, the celiac trunk includes a fourth branch arising directly as the Right Hepatic artery and is considered rare, because the other three branches in this case were “typical” (Left Gastric, Splenic, and Common Hepatic). This variation is not described according to Adachi’s (1928) or Michel’s (1966) classifications of variations of the celiac trunk and hepatic arteries nor as modified by Hiatt (1994).
The case presented is a formalin-fixed donor body, and the dissection was performed as part of preparing a routine prosection for first-year dental students. The vasculature was traced and documented with photos and line drawings noting the course of the right hepatic artery posterior to the portal vein directly to the right lobe of the liver with a branch to the gall bladder.
The hepatobiliary (cystohepatic) triangle (sometimes called Calot’s triangle) serves as an essential surgical landmark involving the cystic duct, common hepatic duct, and the inferior surface of the liver. Typically, the cystic artery courses here along with a significant lymph node (Mascagni or Lund). The significance of being aware of potential variations of this arterial system centers around the growing number of cholecystectomies since the introduction of a laparoscopic technique in 1991. Some hepatobiliary surgeons have called for a more systematic, industry-wide pre-laparoscopy checklist.
