Atypical course of the common hepatic artery branch. A case report and review of new classifications of variability of hepatic arteries.

Abstract

Modern achievements in surgical techniques concerning lobectomy, segmentectomy and liver transplantation, but also transcatheter chemoembolization of the arteries require a thorough knowledge of the arterial vascularisation of the liver. Knowledge of the ways of arising and the topography of replaced or accessory hepatic arteries is particularly important here. In the presented paper, we report a case with early bifurcation of the common hepatic artery (EBCHA), which is a rare anatomical variant (1%). It is often overlooked, which can lead to accidental ligation during surgery replaced right hepatic artery and potential very serious complications. However, this case is considered a normal pattern in the classic classifications of hepatic arteries, like some other rare cases that remain unclassified. We present the new CRL and ex-common, right, left(CRL) classifications available in the literature and propose our modification called adv-CRL, considering not only the way of arising, but also the topography of replaced or accessory hepatic arteries.