The anatomy of the common hepatic artery: a computed tomography angiography analysis

The common hepatic artery (CHA) is a major vessel supplying the liver, stomach, pancreas, and duodenum. While typically arising from the celiac trunk, its origin, course, and morphometry exhibit considerable variability, which may complicate hepatobiliary and pancreatic surgery, liver transplantation, and interventional procedures. This study aimed to comprehensively assess the anatomy and morphometry of the CHA using computed tomography angiography (CTA), with attention to clinically relevant variations.

A retrospective analysis was performed on 73 consecutive patients (41 females, 32 males). Each CHA was reconstructed in three dimensions using dedicated software, and its origin, length, diameter, cross-sectional area, and departure angle were measured at standardized points.

The CHA most commonly originated from the celiac trunk (93.2%), with aberrant origins from the superior mesenteric artery (5.5%) and aorta (1.4%). The median distance from the celiac trunk to CHA origin was 35.73 mm, and the median CHA diameter at its origin was 5.55 mm. Proximal to the bifurcation into the proper hepatic and gastroduodenal arteries, the median CHA diameter and cross-sectional area were 5.54 mm and 23.48 mm², respectively.

Although the CHA typically arises from the celiac trunk, clinically significant variants, including superior mesenteric artery, and aorta-derived CHAs, necessitate preoperative recognition to avoid vascular injury during pancreaticoduodenectomy or hepatic resection. The morphometric data presented provide valuable guidance for endovascular procedures, catheter and graft selection, and arterial reconstruction planning, underscoring the importance of routine preoperative vascular mapping with CTA in hepatobiliary and pancreatic surgery.