Early bifurcation of left and right hepatic arteries before entering the porta hepatis

Former MSc Human Anatomy students Leandros Rapteas, Scott Findlater, Rena Taher, Julie Dockerty and their supervisor Abduelmenem Alashkham have presented their work at the British Association of Clinical Anatomists conference in which the common hepatic artery is a branch of the coeliac trunk which continues as the proper hepatic artery and bifurcates into left and right hepatic arteries before entering the hepatic parenchyma.

Both hepatic arteries enter the liver through the porta hepatis and subsequently bifurcate into segmental arteries. The bifurcation pattern of the left and right hepatic arteries of 5 cadavers (2 males and 3 females: mean age of 79.2 years) was studied. In four cadavers the branching pattern followed conventional textbook descriptions. In one male cadaver, the left and right hepatic arteries bifurcated into two segmental arteries before entering the liver. The left hepatic artery followed a short course (<1 cm length) before bifurcating, whereas the right hepatic artery followed a longer tortuous course passing posterolateral to the common hepatic duct. Early bifurcation of the main hepatic arteries outside the liver parenchyma leads to the inclusion of segmental branches within the porta hepatis complicating its anatomical architecture. Knowledge of structures passing through the porta hepatis is necessary for diagnostic procedures and to avoid surgical complications. Thorough understanding of such variants is significant in the preoperative evaluation of liver transplants as it is essential for making appropriate arterial reconstruction adaptations.