Surgical anatomy of hepatic arteries from its origin to segmental branching: A 500 cases CT study

Background: The aim of this study was to present an overview of variations of the hepatic artery from the origin to the segmental branching. Methods: Abdominal Computed Tomography performed on consecutive patients in our tertiary center between 2019 and 2020 were analyzed. Hepatic arterial branching and its relationship to the portal veins were reported. Results: Out of 500 imaging, 16 anatomic patterns were found for the origin of hepatic artery, with 65.6% conventional origin at celiac axis (n = 328); 10 patterns for the left hepatic artery, 23 for segment IV artery, and more than 21 for the right hepatic artery (RHA), with conventional branching in respectively 66.8%, 39.6% and in 46.4% of patients. Conventional anatomy from celiac axis to segmental branching was found in 10.4% of patients. Conclusion: Dedicated thin-section imaging appears to be essential for preoperative planning in liver surgery, given the high variability of arterial distribution and their surgical implications.