The common hepatic artery is a vital blood vessel that plays an essential role in delivering oxygen-rich blood to the liver, stomach, and parts of the pancreas and duodenum. Understanding its origin and branching pattern is fundamental in clinical anatomy, especially during abdominal surgeries, imaging procedures, and managing trauma cases. Its predictable anatomical course is key to ensuring safe and effective interventions involving the upper abdominal organs. Though variations exist, the classic origin and trajectory of the common hepatic artery provide the baseline for most anatomical and surgical references.
Origin of the Common Hepatic Artery
The common hepatic artery typically arises from the celiac trunk, which is one of the three major anterior branches of the abdominal aorta. The celiac trunk itself originates from the abdominal aorta just below the aortic hiatus of the diaphragm, around the level of the T12 vertebra.
The Celiac Trunk
The celiac trunk is a short but wide arterial trunk that quickly divides into three main branches:
- Left gastric artery
- Splenic artery
- Common hepatic artery
These three branches supply the foregut-derived organs, including the liver, stomach, spleen, pancreas, and upper parts of the duodenum. The common hepatic artery is the only branch of the celiac trunk that directly supplies the liver.
Course of the Common Hepatic Artery
After originating from the celiac trunk, the common hepatic artery travels to the right, passing behind the lesser omentum and in front of the portal vein. It gives off several important branches along its course before eventually continuing as the proper hepatic artery. The typical trajectory takes it in close relation to the pancreas and duodenum, which is clinically important during gastrointestinal surgeries.
Anatomical Landmarks
The common hepatic artery is generally located within the hepatoduodenal ligament, which is part of the lesser omentum. It is accompanied by the portal vein and the bile duct, forming the portal triad. These three structures are important in hepatobiliary surgery and liver transplantation procedures.
Branches of the Common Hepatic Artery
Before it becomes the proper hepatic artery, the common hepatic artery gives rise to several significant branches that supply nearby organs. These include:
1. Gastroduodenal Artery
This is one of the major branches of the common hepatic artery. It descends posterior to the first part of the duodenum and gives rise to several smaller arteries, such as:
- Right gastroepiploic artery
- Superior pancreaticoduodenal artery
The gastroduodenal artery plays an important role in supplying the duodenum, head of the pancreas, and greater curvature of the stomach. Its position makes it a common source of bleeding in duodenal ulcers.
2. Right Gastric Artery
This small branch arises either directly from the common hepatic artery or the proper hepatic artery. It travels along the lesser curvature of the stomach and anastomoses with the left gastric artery. It contributes to the stomach’s arterial supply and is significant in gastric surgeries.
3. Proper Hepatic Artery
After giving off the gastroduodenal artery, the common hepatic artery continues as the proper hepatic artery. This artery ascends in the hepatoduodenal ligament and eventually divides into two main branches:
- Right hepatic artery
- Left hepatic artery
These branches supply the functional lobes of the liver. The right hepatic artery often gives rise to the cystic artery, which supplies the gallbladder.
Anatomical Variations
Although the classic origin of the common hepatic artery is from the celiac trunk, anatomical variations are relatively common. These variations are particularly important during liver transplantation, hepatic resections, and diagnostic angiography.
Common Variations Include:
- Replaced hepatic artery: The common hepatic artery may arise from the superior mesenteric artery (SMA) instead of the celiac trunk.
- Accessory hepatic arteries: Additional hepatic arteries may arise from the SMA or left gastric artery, supplementing the main hepatic blood supply.
- Common hepatic artery arising from aorta: In rare cases, the artery originates directly from the abdominal aorta rather than the celiac trunk.
Recognizing these variations preoperatively using imaging techniques like CT angiography is crucial for preventing surgical complications.
Clinical Significance
Surgical Procedures
The common hepatic artery is routinely encountered in various surgical procedures, including:
- Cholecystectomy (gallbladder removal)
- Liver transplantation
- Pancreaticoduodenectomy (Whipple procedure)
- Gastric resections
Injury to this artery or its branches can lead to significant hemorrhage or liver ischemia. Therefore, a precise understanding of its anatomy is essential for surgeons and interventional radiologists.
Interventional Radiology
In hepatic artery embolization procedures used to treat liver tumors or bleeding, the origin and branching pattern of the common hepatic artery are important. Embolization requires precise catheter placement to selectively block the blood flow to targeted liver tissue while sparing healthy regions.
Trauma and Hemorrhage
Blunt or penetrating trauma to the upper abdomen may involve the common hepatic artery. In such cases, prompt imaging and surgical intervention may be necessary to control bleeding and restore adequate hepatic perfusion.
Role in Liver Perfusion
The liver receives a dual blood supply: approximately 75% from the portal vein and 25% from the hepatic artery. The common hepatic artery contributes the arterial component, which is rich in oxygen. While the portal vein supplies nutrient-rich blood from the gastrointestinal tract, the hepatic artery ensures the delivery of oxygen and supports liver metabolism and bile production.
Any obstruction in the common hepatic artery can lead to hepatic ischemia, impaired bile secretion, or liver infarction, especially if portal venous flow is also compromised.
Embryological Perspective
During embryonic development, the abdominal arteries undergo complex changes, including the formation and regression of various ventral splanchnic vessels. The celiac trunk, including the common hepatic artery, emerges from these developmental processes. Understanding embryology helps explain the basis for anatomical variations observed in adults.
The origin of the common hepatic artery from the celiac trunk highlights its foundational role in supplying the liver, stomach, pancreas, and duodenum. With its classic branching pattern and anatomical relationships, the artery is central to abdominal vascular anatomy. Clinicians must also be aware of its potential variations, which may affect surgical planning and interventional approaches. A comprehensive understanding of the common hepatic artery’s origin and course is therefore indispensable in both anatomical education and clinical practice.