Arterial diameter of the celiac trunk and its branches: anatomical study

Luís Augusto Da Silveira,Fernando Braga Cassiano Silveira,Valéria Paula Sassoli Fazan

doi:10.1590/s0102-86502009000100009

Luís Augusto Da Silveira, Fernando Braga Cassiano Silveira + Show 1 more

Open Access

https://doi.org/10.1590/s0102-86502009000100009

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Abstract

PURPOSE: Despite the fact that anatomical variations of the celiac trunk are well explored in the literature, information on these vessels diameters is scanty. The aims of the present study were to describe the arterial diameters of the celiac trunk and its main branches, and to investigate if these diameters are altered in those cases presenting anatomical variations of these vessels. METHODS: Twenty-one formalin fixed adult male cadavers were appropriately dissected for the celiac trunk identification and arterial diameter measurements. Arteries measured included the celiac trunk and its main branches (splenic artery, left gastric artery and common hepatic artery), as the proper hepatic artery, right gastric artery, the left and right hepatic arteries and the gastroduodenal artery. RESULTS: From the 21 cadavers, 6 presented anatomical variations of, at least, one of the above mentioned branches. The average arterial diameter comparisons between groups (normal and variable) clearly showed smaller diameters for variable vessels, but with no significant difference. CONCLUSION: Our data indicates the possibility of a diameter reduction of the celiac trunk main branches in the presence of anatomical variations. This should be taken into account on the selection for the liver transplantation donors.

Highlights

Despite that the celiac trunk anatomical variations are well explored in the literature, information on the arterial diameter of its main branches is still scanty
The right lobe grafts have been the main type of partial liver grafts for adult-to-adult living donor liver transplantation and the anatomy of the right liver must be intensively investigate to assure safety to the donor and prevention of recipient complications[3]
As a sufficient supply of arterial blood is indispensable for survival of a right lobe graft, special attention must be paid to the anatomy of the right hepatic artery, including the number and diameter of the vessels[3]

Summary

Introduction

Despite that the celiac trunk anatomical variations are well explored in the literature, information on the arterial diameter of its main branches is still scanty. Arterial diameter of celiac trunk hepatic branches has gained importance especially due to development of techniques for liver transplantation. Vascular and biliary reconstructions are technically difficult in living-related liver transplantation[1] because of the use of a partial graft with small-diameter vessels and ducts. Hepatic artery trombosis is one of the most devastating postoperative living-related liver transplantation complication and this risk is related to the use of small diameter arteries (< 2 mm)[1]. The post-operative ischemic damage to the liver graft as a result of hepatic artery stenosis is another serious complication after liver transplantation. In these cases, surgical re-anastomosis is often difficult and the angioplasty of the stenotic artery might be an option. Another situation that involves mandatory knowledge of the hepatic arteries diameters is the hepatic arterial infusion chemotherapy for treatment of hepatic metastatic tumors[4], so the correct size of the catheter can be safely chosen

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