IntroductionThe anatomy of the hepa

Introduction

The anatomy of the hepatic artery (HA) is of great importance in general surgery and in hepatic surgery, especially in liver transplantation (LT), as well as in many radiological procedures such as trans-arterial chemo-embolization for hepatic tumors. The vascular anatomy of the liver is variable [19]. In dominant pattern, common hepatic artery (CHA) from celiac trunk irri￾gates the liver by the proper hepatic artery (PHA), which gives left and right hepatic arteries in 52–79% of cases [1, 10, 12–14]. An international classification concerning main variations of the vascular anatomy of the liver was proposed by Michels [14] in 1966 and modified by Hiatt et al. [12] in 1994. Additionally, many anatomic, surgical and radiological studies have described other rare hepatic arterial variations [6, 10, 13]. Hepatic transplantation, which has become a world￾wide procedure and the treatment of choice for many hepatic diseases in their end stages, depends on meticu￾lous recognition of anatomy of hepatic and biliary tree and especially liver blood supply, since the absence of an adequate blood supply results in necrosis and loss of the graft due to ischemic biliary or parenchymal complica￾tions [9]. These arguments encouraged us to restudy hepatic arterial anomalies to identify other variations, which may need arterial reconstruction procedures to avoid arterial complications and to conserve the graft. The aim of this study concerning more than 900 cases of HA surgical dissections during graft harvesting and LT was to assess type and frequency of HA variations and to approach some of the surgical problems and com￾plications when such anomalies could be missed.