ANATOMICAL VARIATIONS IN THE ORIGIN OF HEPATIC ARTERY IN PATIENTS UNDERGOING HEPATOBILLIARY SURGERY AT KHYBER TEACHING HOSPITAL PESHAWAR

Objectives: The aim of this study was to contribute to the knowledge of the hepatic vascular anatomy and its variations
in people belonging to our part of the world mainly Khyber Pakhtunkhwa and adjoining areas of Afghanistan.
Design: descriptive study
Setting and duration: This study was of one year duration conducted at the Surgical B unit of Khyber Teaching Hospital,
Peshawar in collaboration with other surgical units where hepatobilliary surgeries were performed.
Methodology: A total of 139 cases both male and females of all ages were included in the study who underwent different
hepatobilliary surgeries. After identification of the common hepatic artery, its course any abnormality or variation
in its course was noted and recorded.
Results: Common hepatic artery was present and originated from Celiec trunk in all 100% of cases and was entirely to
the left of common bile duct and ventral to portal vein, ninety five (68.6%) cases had typical textbook branching pattern
i.e common hepatic artery giving gastroduedenal artery and then dividing into right hepatic artery and left hepatic
artery with right gastric artey. Aberrant arteries were present in 60(42.8%) of cases all of which were present either as
replaced arteries or accessory aberrant arteries. In 18 (12.8%) cases there was a single aberrant artery, present as either
replaced or accessory while in 18 (12.8%) had more then one aberrant artery present as either replaced or accessory
replaced or accessory , 16 (11.8%) cases had two aberrant arteries while 2 (1.4%) cases had three aberrant arteries.
Conclusion: The findings of the present study highlight the fact that the distribution of common hepatic artery, its
origin, its branching pattern is variable and that anatomic variations in its anatomy occur in high percentage of cases.