Topographical relationship between the accessory hepatic duct and the hepatic artery system

Area of Science:

• Surgical Anatomy
• Hepatobiliary Surgery
• Vascular Anatomy

Background:

• Hepatic biliary and arterial injuries are common cholecystectomy complications.
• Anatomical variations of hepatic ducts, including accessory hepatic ducts (AHDs), necessitate careful surgical consideration.
• The topographical relationship between AHDs and hepatic arteries remains poorly understood.

Purpose of the Study:

• To investigate the anatomical variations and topographical relationships of accessory hepatic ducts (AHDs) with hepatic arteries.
• To provide crucial anatomical data for preventing biliary and arterial injuries during cholecystectomy.

Main Methods:

• Cadaveric dissection was performed on 59 individuals.
• The presence, number, and origin of accessory hepatic ducts (AHDs) were documented.
• The spatial relationship between AHDs and the hepatic artery system was analyzed.

Main Results:

• Accessory hepatic ducts (AHDs) were identified in 7 out of 59 (11.9%) cadavers.
• Most cases (6/7) presented a single AHD, with one case showing double AHDs.
• Right AHDs coursed anterior to the right hepatic artery, while left AHDs ran posterior to the hepatic arteries, demonstrating a reversed topographical relationship.

Conclusions:

• Accessory hepatic ducts (AHDs) are present in a significant percentage of the population, highlighting their clinical relevance.
• The reversed topographical relationship between right/left AHDs and hepatic arteries underscores the need for detailed pre-operative anatomical assessment.
• Understanding these AHD-hepatic artery relationships is vital for minimizing iatrogenic injuries during cholecystectomy.