Vascular Supply to the Liver: A Report of a Rare Arterial Variant

Johnson, Peter; Cawich, Shamir O; Shah, S.; Gardner, Michael L. G.; Roberts, Patrick; Stedman, Brian; Pearce, Neil

doi:10.1155/2013/969327

Cited by 8 publications

(4 citation statements)

References 14 publications

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“…Table shows a summary of extrahepatic variations not classified by Michels, observed in the current study and those described by other authors. Bold‐italic letters show UC variations found also by us .…”

Section: Discussionsupporting

confidence: 73%

Extrahepatic arteries of the human liver - anatomical variants and surgical relevancies

et al. 2015

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SummaryThe purpose of our study was to investigate the anatomical variations of the extrahepatic arterial structures of the liver with particular attention to rare variations and their potential impact on liver surgery. A total of 50 human abdominal organ complexes were used to prepare corrosion casts. A multicomponent resin mixture was injected into the abdominal aorta. The portal vein was injected with a different colored resin in 16 cases. Digestion of soft tissues was achieved using cc. KOH solution at 60-65°C. Extrahepatic arterial variations were classified according to Michels. All specimens underwent 3D volumetric CT reconstruction. Normal anatomy was seen in 42% of cases, and variants were seen in the other 58%. No Michels type VI or X variations were present; however, in 18% of cases the extrahepatic arterial anatomy did not fit into Michels' classification. We report four new extrahepatic arterial variations. In contrast to the available data, normal anatomy was found much less frequently, whereas the prevalence of unclassified arterial variations was higher. We detected four previously unknown variations. Our data may contribute to the reduction of complications during surgical and radiological interventions in the upper abdomen.

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Section: Discussionsupporting

confidence: 73%

Extrahepatic arteries of the human liver - anatomical variants and surgical relevancies

et al. 2015

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“…We also agree with Hashimoto et al[29] that annual volume only contributes a partial assessment and that there is also a substantial contribution by surgeon training and experience. In this regard, we attribute our outcomes to the unit staff (1) having appropriate training; (2) developing an intimate knowledge of the health care system in which they work; (3) fostering a spirit of collective teamwork; (4) maintaining due diligence in care administration; (5) continued audit; and (6) knowledge of population-based data[30,31,32].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes after major hepatectomy are acceptable in low-volume centers in the Caribbean

Cawich¹,

Maharaj²,

Naraynsingh³

et al. 2019

WJH

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BACKGROUND Major hepatectomies are routinely performed because they are often the only curative treatment for metastatic liver disease. There has been a trend to concentrate major hepatectomies in referral hospitals that perform these operations at high volumes. These high volume referral centers are usually located in developed countries, but many patients in developing nations are not able to access these centers because of financial limitations, lack of social support and/or travel restrictions. Therefore, local hospitals are often the only options many of these patients have for surgical treatment of metastatic liver disease. This is the situation in many Caribbean countries. AIM To determine the clinical outcomes after major liver resections in a low-resource hepatobiliary center in the Caribbean. METHODS We prospectively studied all patients who underwent major liver resections over five years. The following data were extracted: patient demographics, diagnoses, ECOG status, operation performed, post-operative morbidity and mortality. Statistical analyses were performed using SPSS ver 16.0 RESULTS There were 69 major liver resections performed by two teams at a mean case volume of 13.8 major resections/year. Sixty-nine major hepatic resections were performed for: colorectal liver metastases 40 (58%), non-colorectal metastases 9 (13%), hepatocellular carcinoma 8 (11.6%), ruptured adenomas 4 (5.8%), hilar cholangiocarcinomas 4 (5.8%), hemangiomata 2 (2.9%), trauma 1 (1.5%) and hepatoblastoma 1 (1.5%). Twenty-one patients had at least one complication, for an overall morbidity rate of 30.4%. There were minor complications in 17 (24.6%) patients, major complications in 11 (15.9%) patients and 4 (5.8%) deaths. CONCLUSION There are unique geographic, political and financial limitations to healthcare delivery in the Caribbean. Nevertheless, clinical outcomes are acceptable in the established, low-volume hepatobiliary centers in the Eastern Caribbean.

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“…(4,5) There are several reports in the literature regarding hepatic artery variations that do not fit in Michel classification. (6)(7)(8)(9) In this article, we describe the anatomical variation of the hepatic artery of donors and potential liver donors that had a triphasic CT scan for anatomical evaluation, with special emphasis on variations that were not described by Michel.…”

Section: Introductionmentioning

confidence: 99%

Anatomical variations of the hepatic artery: a closer view of rare unclassified variants

et al. 2022

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Background: Defining the hepatic artery anatomy is of great importance for both surgeons and radiologists. Michel classification was designed to classify hepatic artery variations. Nevertheless, there are variations that do not fit into this classification. In this study, we aim to define the incidence of all variations in a healthy liver donor by reviewing their CT scan with special emphasis on variations that do not fit in any of the Michel classes. Materials and methods: A retrospective analysis of CT scan of donors and potential liver donors who were evaluated by triphasic CT scan. The CT scans were reviewed independently by a radiologist and two transplant surgeons. Cases that did not fit in any of the Michel classes were classified as class 0. Results: Out of 241 donors, 210 were classified within the Michel classification, of which 60.9 % were class I and 9.1% class II. Thirty-one donors (12.9%) classified as class 0. Of which, nine, three, two and three had replaced right hepatic artery from pancreaticoduodenal artery, gastroduodenal artery, aorta and celiac artery, respectively. Two and 6 donors had accessory right hepatic artery from pancreaticoduodenal artery and gastroduodenal artery respectively. Segment 4 artery originated from left and right hepatic artery in 56.8% and 31.9%, respectively. Conclusions: A great caution should be taken when evaluating the hepatic artery anatomy, clinicians should anticipate and be familiar with the rare unclassified variations of the hepatic artery.

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Vascular Supply to the Liver: A Report of a Rare Arterial Variant

Cited by 8 publications

References 14 publications

Extrahepatic arteries of the human liver - anatomical variants and surgical relevancies

Extrahepatic arteries of the human liver - anatomical variants and surgical relevancies

Clinical outcomes after major hepatectomy are acceptable in low-volume centers in the Caribbean

Anatomical variations of the hepatic artery: a closer view of rare unclassified variants

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