Kosin Med J.  2018 Dec;33(3):463-467. 10.7180/kmj.2018.33.3.463.

Common Hepatic Artery Originating from Left Gastric Artery: A Rare Variant Encountered in Gastric Cancer Surgery

• Choi CI
• Jeon TY

• KMID: 2442560
• DOI: http://doi.org/10.7180/kmj.2018.33.3.463

Abstract

The hepatic artery can have numerous variations. However, a common hepatic artery originating from the left gastric artery and the entire hepatic blood supply furnished by the left gastric artery is an extremely rare anomaly. We encountered this anomaly in a patient with advanced gastric cancer. A surgeon should recognize this image appearance and identify the anomaly. Without knowledge of this anomaly and given the strategy for extensive lesser sac dissection generally employed during gastric cancer surgery, a surgeon could easily inadvertently divide this vessel, resulting in critical liver damage. We report a case of common hepatic artery originating from left gastric artery and review of the literatures.

Keyword

Anatomic variation; Gastrectomy; Hepatic artery; Stomach neoplasms

MeSH Terms

Anatomic Variation
Arteries*
Gastrectomy
Hepatic Artery*
Humans
Liver
Peritoneal Cavity
Stomach Neoplasms*

Figure

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  Fig. 1 Preoperative abdominal computed tomography scan. (A) There is only the splenic artery present along the upper border of pancreas (red arrow). Celiac trunk was presented with yellow arrow. (B) Common hepatic artery runs toward hepatic hilum along the lower border of left lobe (yellow arrow).

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  Fig. 2 Intraoperative finding. The left gastric artery (LGA) is arising from celiac trunk, two accessary arteries were branched to lesser curvature (yellow arrows) and then, it run toward hepatic hilum along the lower border of left lobe (black arrow).

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  Fig. 3 CT angiography. The left gastric artery (LGA) originates from the celiac trunk. The left gastric artery angulated and run toward hepatic hilum and branches into left hepatic artery (LHA), the right hepatic artery (RHA) and gastroduodenal artery (GDA). There is no communication between hepatic artery and superior mesenteric artery (SMA). Black arrow; common hepatic artery, gray arrow; branches of LGA, white arrow; GDA

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