INTRODUCTION & BACKGROUND:

The hepatic hilum includes the hepatic arterial supply, portal venous system, and hepatic bile ducts, which all vary in measurements and branching pattern. The complete hepatic vasculature consists of the common hepatic artery (CHA), proper hepatic artery (PHA), right hepatic artery (RHA), left hepatic artery (LHA), cystic artery (CA), and gastroduodenal artery (GDA). The arterial length and diameter have significant implications for liver transplants, liver resections, and hepatobiliary surgeries. In this study, measurements were taken of the entire hepatic arterial vasculature originating from the celiac trunk (CT) to investigate the vessels’ respective diameters and lengths.

HYPOTHESIS:

The measurement of variations in the length and diameter of the hepatic vasculature will contribute to existing literature and the associated hepatic clinical implications.

METHODS:

Data collection and dissection were performed at Tilman J. Fertitta Family College of Medicine and Baylor College of Medicine. Thirty-six cadaveric samples were dissected at the hilum of the liver along with the surrounding vasculature. The CHA measurement extended from the CT's origin to the bifurcation of the CHA. The PHA was measured beginning at the CHA bifurcation to the point of PHA bifurcation. Measurement of the GDA began at its branch point from the CHA to the Anterior Superior Pancreaticoduodenal Artery. Both the RHA and LHA were measured at the bifurcation origin point to their segmental intrahepatic branching. The CA was measured from its branching point off of the RHA to the termination point on the gallbladder. A vernier caliper was used to measure all vasculatures’ lengths and their respective external diameters.

RESULTS:

In thirty-six cadaveric samples, the mean distance between the CT and the CHA was 33.44 mm, with a diameter of 8.88 mm, an increase compared to other studies. The mean length of the PHA was 21.53 mm, with a diameter of 5.98 mm. The LHA measured a mean of 30.39 mm in length and 3.97 mm in diameter, revealing no substantial differences compared to other studies. The RHA had a mean length of 29.65 mm and a mean diameter of 4.76 mm. The GDA averaged 32.33 mm in length and 4.34 mm in diameter. Lastly, the CA had a mean length of 24.01 mm and a diameter of 2.33 mm.

DISCUSSION/CONCLUSION:

Understanding these measurements and variations in arterial anatomy can provide specific guidance and enhance safety in surgeries such as liver transplants, which are particularly vulnerable to complications like intraoperative bleeding and necrosis. Moreover, knowledge of the expected values of arterial diameter and length can contribute to hemodynamic data, potentially assisting in the early diagnosis of arterial stenosis. Further, small arterial caliber is known to contribute to hepatic artery thrombosis. Our study's findings give insight into the distances and diameters of hepatic vasculature and its tie to hepatic clinical implications.