Topographical relationship between the accessory hepatic duct and the hepatic artery system
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ORIGINAL ARTICLE
Topographical relationship between the accessory hepatic duct and the hepatic artery system Takashi Tanaka1 · Takayuki Nakada2 · Tetsufumi Ito1 · Rieko Kominami1 · Takahiro Sonomura3 · Miyuki Kagaya1 · Katsushi Kawai1 · Satoru Honma1 Received: 13 April 2020 / Accepted: 1 September 2020 © Japanese Association of Anatomists 2020
Abstract Hepatic biliary injury is one of the most common complications in cholecystectomy and is frequently accompanied by arterial injuries. Because there are several anatomical variations of the hepatic ducts, including the accessory hepatic ducts (AHDs), it is important to consider not only the anatomical position of the hepatic ducts but also those of the AHDs in cholecystec‑ tomy. However, the topographical relationships between the AHDs and the hepatic arteries are still poorly understood. In the present study we show that AHDs were observed in 7 out of 59 (11.9%) of the cadavers. There was a single AHD in the 6 out of the 7 cadavers and double AHDs in one. In these cases, the right AHDs emerged from the anterior medial segment of the liver piercing the parenchyma, while the left AHDs emerged directly from the anterior part of the caudate lobe. The right AHDs ran anterior to the right hepatic artery, while the left AHDs ran posterior to the hepatic arteries. The topographical relationship between the AHD and the hepatic artery system was thus reversed in the cases of the right and the left AHDs. Keywords Accessory hepatic duct · Common hepatic duct · Cystic duct · Hepatic artery · Variation Abbreviations AHD Accessory hepatic duct CA Cystic artery CBD Common bile duct CD Cystic duct CHA Common hepatic artery CHD Common hepatic duct CT Celiac trunk GdA Gastroduodenal artery HD Hepatic duct IPdA Inferior pancreaticoduodenal artery LGA Left gastric artery LHA Left hepatic artery Takashi Tanaka, Takayuki Nakada contributed equally to this work. * Satoru Honma honmanat@kanazawa‑med.ac.jp 1
Department of Anatomy II, Kanazawa Medical University, 1‑1 Daigaku, Uchinada, Kahoku, Ishikawa 920‑0293, Japan
2
Anatomy Center, Kanazawa Medical University, 1‑1 Daigaku, Uchinada, Kahoku, Ishikawa 920‑0293, Japan
3
Department of Anatomy, School of Dentistry, Asahi University, 1851 Hozumi, Mizuho, Gifu 501‑0296, Japan
LHD Left hepatic duct MHA Middle hepatic artery PHA Proper hepatic artery PSPdA Posterior superior pancreaticoduodenal artery PV Portal vein RGA Right gastric artery RHA Right hepatic artery RHD Right hepatic duct RPSHD Right posterior sectorial hepatic duct SA Splenic artery SdA Supraduodenal artery SMA Superior mesenteric artery
Introduction According to Couinaud (1957) and Gazelle et al. (1994), the liver consists of eight segments, which have their own individual portal vein (PV) and biliary systems. Puente and Bannura (1983) indicated that the usual biliary system was observed in 57.6% of the cases. Lamah et al. (2001) reviewed and classified the various variations that exist in the extrahepatic biliary system. Accessory hepat
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