Published date: Sep 30 2022

Journal Title: Sudan Journal of Medical Sciences

Issue title: Sudan JMS: Volume 17 (2022), Issue No. 3

Pages: 366–375

DOI: 10.18502/sjms.v17i3.12121

Nidal Abubaker Haruntarigfuture@gmail.comUniversity of Science and Technology, Collage of Medicine, Department of Anatomy, Omdurman-Sudan

Mohamed A/Salam NureinAlbayan College for Science and Technology, Department of Anatomy, Khartoum- Sudan

Taher Osman AliNational Ribat University, Collage of Medicine, Department of Anatomy, Khartoum - Sudan

Tarig Gasim Mohamed AlarabiOrotta College of Medicine and Health Sciences, Department Medical Sciences, Unit of Anatomy and Embryology, Asmara, Eritrea.

Kamal Zaki AliKing Khalid University, Collage of Medicine, Department of Anatomy, Abha - Kingdom of Saudi Arabia

Heitham Mutwakil MohammedKing Khalid University, Collage of Medicine, Department of Anatomy, Abha - Kingdom of Saudi Arabia

Asim Mohammed AbdallaKing Khalid University, Collage of Medicine, Department of Anatomy, Abha - Kingdom of Saudi Arabia

Abulqasim M. B. SiddeegKing Khalid University, Collage of Medicine, Department of Anatomy, Abha - Kingdom of Saudi Arabia

Ali Gad Karim A. SalihKing Khalid University, Collage of Medicine, Department of Anatomy, Abha - Kingdom of Saudi Arabia

Samy Ismail AhmedNajran University, Collage of Medicine, Department of Anatomy, Najran - Kingdom of Saudi Arabia

Hepatobiliary surgery through laparoscopic approach is becoming a routine. Knowledge of extrahepatic arterial tree is essential for surgical and imaging procedures. Anatomical complexity is expected since the liver is developed by mergingof lobules with its separate blood supply. This makes a wide range of variations in the pattern of vascular arrangement and so reinforces the need for an accurate understanding of full spectrum of variations. This study aimed to investigate the variations in origin and distribution of extrahepatic arterial supply. Fifty volunteers (32 males and 18 females) aged 20–70 years were randomly recruited from the department of CT scan in Al Amal Hospital, Khartoum North, Sudan. The patients were already candidates for CT angiography with contrast for conditions other than hepatobiliary diseases. The reported data is related to those who accepted to participate in the study. Patients with history of hepatobiliary disease were excluded. 3D views of the scans were treated and the extrahepatic arterial tree was traced in a computer-based software. Key findings suggest that Michel’s classification was considered the standard template for description – 76% of them showed Michel’s type I classification. Types III and V constituted about 2%. About 4% of the cases were represented by types VI and IX. Other types of variations constituted about 12%. To conclude, although type I classification which describes the textbook pattern of hepatic artery distribution was significantly detected among the Sudanese population, other variants were to be considered since they are related to major arteries like aorta and superior mesenteric.

Keywords: hepatic artery variations, CT angiography, hepatobiliary, vascular abnormalities

[1] Saritha, S. (2014). Surgical anatomy of coeliac trunk variations an autopsy series of 40 dissections. Global Journal of Medical research: i Surgeries and Cardiovascular System, 14(1), 41–46.

[2] Pulakunta, T., Potu, B. K., Gorantla, V. R., Vollala, V. R., & Thomas, J. (2008). Surgical importance of variant hepatic blood vessels: A case report. Jornal Vascular Brasileiro, 7(1), 84–86. https://doi.org/10.1590/S1677-54492008000100016

[3] Jelev, L., & Angelov, A. (2015). A rare type of hepatobiliary arterial system in man– presence of accessory left and replaced right hepatic arteries and double cystic arteries. Anatomy, 9(2), 100–103. https://doi.org/10.2399/ana.15.010

[4] Staśkiewicz, G., Torres, K., Denisow, M., Torres, A., Czekajska-Chehab, E., & Drop, A. (2015). Clinically relevant anatomical parameters of the replaced right hepatic artery (RRHA). Surgical and Radiologic Anatomy, 37(10), 1225–1231. https://doi.org/10.1007/s00276-015-1491-y

[5] Chiang, K., Chang, P.-Y., Lee, S. K., Yen, P. S., Ling, C. M., Lee, W. S., Lee, C. C., & Chou, S. B. (2005). Angiographic evaluation of hepatic artery variations in 405 cases. Chinese Journal of Radiology-Taipei, 30(2), 75.

[6] Zagga, A., Usman, J. D., Abubakar, B., & Tadros, A. T. (2010). Accessory right hepatic artery originating from the superior mesenteric artery: Report on three cadaveric cases from Sokoto, North-Western Nigeria and review of literature. Orient Journal of Medicine, 22(1–4). https://doi.org/10.4314/ojm.v22i1-4.63575

[7] Saba, L. (2012). CT Imaging of hepatic arteries. In: L. Saba (Ed.) Computed tomography – Clinical applications. InTech Open. https://doi.org/10.5772/24770

[8] Özen, K., Büyükmumcu, M., Özbek, O., Kabakçi, A. A., & Şahin, G. Case report: Hepatomesenteric trunk. İbni Sina Tİbni Sina Tip Bilimleri Dergisi, 1(3), 52–55.

[9] Nayak, S., Ashwini, L. S., Swamy Ravindra, S., Abhinitha, P., Marpalli, S., Patil, J., & Ashwini Aithal, P. (2012). Surgically important accessory hepatic artery-A case report. Journal of Morphological Sciences, 29(3), 187–188.

[10] Sathidevi, V., & Rahul, U. (2013). Coeliac trunk variations-case report. International Journal of Scientific and Research Publications, 3(2), 1–4.

[11] Sebben, G. A., Rocha, S. L., Sebben, M. A., Filho, P. R. P., & Gonçalves, B. H. H. (2012). Variations of hepatic artery: Anatomical study on cadavers. Revista do Colégio Brasileiro de Cirurgiões, 40(3), 221–226.

[12] López-Andújar, R., Moya, A., Montalvá, E., Berenguer, M., De Juan, M., San Juan, F., Pareja, E., Vila, J. J., Orbis, F., Prieto, M., & Mir, J. (2007). Lessons learned from anatomic variants of the hepatic artery in 1,081 transplanted livers. Liver Transplantation, 13(10), 1401–1404. https://doi.org/10.1002/lt.21254

[13] Suzuki, T., Nakayasu, A., Kawabe, K., Takeda, H., & Honjo, I. (1971). Surgical significance of anatomic variations of the hepatic artery. American Journal of Surgery, 122(4), 505–512. https://doi.org/10.1016/0002-9610(71)90476-4

[14] Hiatt, J. R., Gabbay, J., & Busuttil, R. W. (1994). Surgical anatomy of the hepatic arteries in 1000 cases. Annals of Surgery, 220(1), 50–52. https://doi.org/10.1097/00000658- 199407000-00008

[15] Kamath, B. (2015). A study of variant hepatic arterial anatomy and its relevance in current surgical practice. International Journal of Anatomy and Research, 3(01), 947–953. https://doi.org/10.16965/ijar.2015.124

[16] Özdemir, F.A.E., Ökten, R. S., Özdemir, M., Ereren, M., Küçükay, F., Tola, M., & Şenol, E. (2014). Evaluation of hepatic vascular anatomy by multidetector computed tomography angiography in living liver right lobe donors. Akademik Gastroenteroloji Dergisi, 13(1), 01–06.

[17] Saidi, H., Karanja, T. M., & Ogengo, J. A. (2007). Variant anatomy of the cystic artery in adult Kenyans. Clinical Anatomy, 20(8), 943–945. https://doi.org/10.1002/ca.20550

[18] Gümüs, H., Bükte, Y., Özdemir, E., Sentürk, S., Tekbas, G., Önder, H., Ekici, F., & Bilici, A. (2013). Variations of the celiac trunk and hepatic arteries: A study with 64- detector computed tomographic angiography. European Review for Medical and Pharmacological Sciences, 17(12), 1636–1641.

[19] Saylisoy, S., Atasoy, C., Ersöz, S., Karayalçin, K., & Akyar, S. (2005). Multislice CT angiography in the evaluation of hepatic vascular anatomy in potential right lobe donors. Diagnostic and Interventional Radiology (Ankara, Turkey), 11(1), 51–59.