A rare type of hepatobiliary arterial system in man – presence of accessory left and replaced right hepatic arteries and double cystic arteries

In addition to the normal textbook description, the hepatobiliary arterial system in man shows many anatomical variations that have definite clinical importance. The presence of aberrant hepatic and cystic arteries may lead to a number of iatrogenic injuries during some open surgical or endoscopic procedures. In the course of routine students’ dissection of a 62-year-old Caucasian female cadaver, an interesting pattern of the arterial supply to the liver and gallbladder was described. In the case reported, an unusually small proper hepatic artery was identified supplying the left liver lobe. In addition, an accessory left hepatic artery was also observed arising from the left gastric artery. Another large variant artery to the liver was also dissected that started from the first portion of the superior mesenteric artery – known as replaced right hepatic artery. The gallbladder, in this case, had two supplying arteries of different origin arising from the small proper hepatic artery and replaced right hepatic artery. This rare and complicated arterial variation might be of considerable importance for liver and gallbladder resections, liver transplants and laparoscopic procedures in this area.