Abstract:
Background
Studying of individual variations of hepatic and cystic artery architectonics, including the derivation, angle of
convergence, bifurcation, sizes, etc.; defining the anatomic diversity of biliary tracts and cystic duct; confirmation of
literature data about a constant detection of the Calot’s triangle in its classical borders, as an anatomical landmark for
localization and mobilization of a single or multiple cystic arteries.
Material and methods
Part of the material was examined by the method of anatomical dissection, another considerable part of it – 45
preparations – by injection with self-solidifying plastic mass «REDONT – 03®» and subsequent etching.
Results
The right hepatic artery (RHA) in its classic version has a path oriented between the hepatic artery proper and the
hepatic portal vein, but in some cases it presents a variable direction in relation to the main bile path.
In 40 cases (88.8%) the right hepatic artery was located between the other two important formations of the hepatoduodenal
ligament and only in 5 cases (11.2%) the RHA presents a path anterior to the main bile path.
Conclusions
The right hepatic artery in relation to the main bile path is located predominantly between the common hepatic
duct and the hepatic portal vein (90.5% of cases on macroscopic pieces and 88.8% on injected ones) and only
sometimes (9.5% and 11.2% respectively) passes anterior to the common hepatic duct approaching the wall of the
gallbladder, its neck or duct, with which it can come into direct contact.
The right hepatic artery, being anterior to the common hepatic duct, can form a curve with an anteriorly oriented
convexity, called the „caterpillar hump” (4.4%) or can serve as a source of multiple cystic arteries (6.6%).
The atypical location of the right hepatic artery can complicate cholecystectomy, constituting a major risk factor
in causing iatrogenic complications.
