Abstract
Objectives: Hepatic arteries (HA) are an important source of blood supply to the liver and the biliary system. The HA is associated with anatomical variations that have implications for surgical procedures. The purpose of this study is to identify the HA variations on computed tomographic angiography imaging in patients presenting to a single tertiary care centre in Sri Lanka. The reported incidence of variations in the hepatic arterial anatomy varies from 20.0 % to 49.0%.
Methods: This is a cross-sectional descriptive study. Patients undergoing computed tomographic scan (CT) of the abdomen with CT angiogram were included in this study. Data on the patient’s age, gender, details on branching pattern variations of the HA were obtained. Incomplete records, images with artefacts, patients with pathologies distorting the hepatic arterial anatomy and the patients who have undergone previous interventions near the area of study were excluded from the analysis. HA variations were classified according to the Michael classification system. 100 images were included in the analysis.
Results: There were 63 [63.0%] males and 37 [37.0%] females. The mean age was 49.8 years (17-100). 74 (74.0%) had type I (normal pattern) anatomy. HA variations were found in 26 (26.0%) images. The commonest variation observed was an accessory LHA in 12 (12.0%) followed by a replaced LHA in 7 (07.0%). The variations occurred in 7 females (7/37 – 18.9%) and 19 males (19/63 – 30.2%) however, this difference was not statistically significant (p-0.3168).
Conclusions: This CTA-based study gives insight into the hepatic artery variations in the study population. This is likely to be the case with the Sri Lankan population. A countrywide study from multiple centres with a larger sample size is needed to know the actual pattern in Sri Lanka.
Keywords: Hepatic Artery Variations, Computerised Tomographic Angiogram, Sri Lanka