[Hepatic artery variants originating from the superior mesenteric artery--the surgical implications]

The hepatic accessory (or aberrant) arteries appear as a consequence of modifications during the embryological development of the splanchnic arterial system. These arteries emerge from the first segment of the superior mesenteric artery and have a variable trajectory, of importance being the relations with the head of the pancreas and with the extra-hepatic biliary ducts. Taking into account the appreciable frequency of these arteries (19.5%), the relations and the surgical implications, I consider that the presence of these arteries should be determined mandatory by means of selective pre-surgical arteriography; when this procedure is not available the presence of extra-arteries emerging from the superior mesenteric artery (S.M.A.) can be speculated when pulsations in the free border of the lesser omentum are detected.