Anomalous arterial ramification in the right liver

Area of Science:

• Surgical anatomy
• Vascular imaging
• Hepatobiliary surgery

Background:

• Hepatectomy requires precise understanding of liver vasculature.
• Individual arterial and portal venous division is a common surgical approach.
• Potential for anatomical variations necessitates thorough preoperative evaluation.

Purpose of the Study:

• To determine the safety of individual arterial and portal venous division during hepatectomy.
• To investigate the prevalence of anomalous arterial ramification in the right liver.
• To assess the utility of 3D imaging in identifying these variations.

Main Methods:

• Three-dimensional (3D) reconstruction imaging was utilized.
• Computed tomography during angiography (CTA) was performed on 87 patients.
• Preoperative assessment focused on intrahepatic tumors and right hepatic artery (RHA) branching patterns.

Main Results:

• The right hepatic artery (RHA) bifurcated normally in 76 patients.
• Anomalous RHA ramification was identified in 22 patients (25.3%).
• Variations included sector-intersecting arteries and complex branching into more than two vessels.

Conclusions:

• Preoperative 3D imaging is crucial for detecting anomalous RHA ramification.
• Caution is advised during arterial dissection in the intrafascial approach.
• 3D imaging aids in planning safer hepatectomy procedures by revealing vascular anomalies.