A Surgically Relevant Celiac Trunk Variant featuring Retro‐portal Blood Supply to the Gallbladder and the Right Lobe of the Liver

Abstract

Variations in celiac trunk anatomy have surgical, radiological and clinical significance, as the derivative arteries (common hepatic, splenic, and left gastric arteries are typically direct branches, all of which course in front of the portal vein in most individuals) supply the liver, stomach, duodenum, pancreas, and spleen. Here we describe a rare celiac trunk variant noted in routine dissection for undergraduate medical students in a 52-year-old male cadaver in which a celiac trunk gives rise to one (left) inferior phrenic artery and two common stems. The first common stem gives rise to left gastric and replaced right hepatic arteries. Notably, the replaced right hepatic artery courses retro-portally and culminates in several branches that supply the right lobe of the liver, in addition to supplying the gallbladder via a cystic artery found within the cystohepatic triangle. The second common stem gives rise to common hepatic and splenic arteries. Awareness of this specific anomaly, particularly the retro-portal right hepatic artery, will have clinical relevance to surgical interventions and radiologic imaging concerning the right side of the liver, the gallbladder, the pancreas and the duodenum. Awareness of this variant will also be relevant to trans-arterial chemo-embolization and trans-arterial radio-embolization approaches for hepatic tumours.