Anatomical Science International

, Volume 88, Issue 2, pp 93–96 | Cite as

Right hepatic artery traveling anteriorly to the common bile duct

Case report


The topographic relationship between arteries and hepatobiliary ducts can be crucial during cholecystectomy. We observed the right hepatic artery traveling a rare route in a 91-year-old male. The common hepatic artery gave off the left hepatic, the right gastric, the gastroduodenal, and the right hepatic arteries consecutively without forming the proper hepatic artery. The right hepatic artery crossed the common bile duct anteriorly, ascended on the right side of the duct, passed the cystic duct posteriorly, and entered the right lobe of the liver. The so-called 9 o’clock artery running on the right side of the common hepatic and common biliary is reasonably speculated to be the aberrant right hepatic artery as presently shown. Developmental and clinical issues are discussed.


Common bile duct Cystic artery Cystic duct Posterior superior pancreaticoduodenal artery Right hepatic artery 



Accessory left gastric artery


Cystic artery


Common bile duct


Cystic duct


Common hepatic artery


Celiac trunk


Dorsal pancreatic artery


Falciform ligament


Gastroduodenal artery


Gallbladder fossa


Hepatic nerve


Inferior phrenic artery


Left gastric artery


Left hepatic artery


Posterior superior pancreaticoduodenal artery


Portal vein


Right gastric artery


Right hepatic artery


Right portal vein


Splenic artery


Superior mesenteric artery


Splenic vein


Conflict of interest



  1. Adachi B (1928) Das Arteriensystem der Japaner. Band I. Maruzen, Kyoto, pp 53–56Google Scholar
  2. Aizawa Y, Ohtsuka K, Kumaki K (1996) Examination of the courses of the arteries in the axillary region. 2. The course of the axillary arteries in the case of Adachi’s C-type brachial plexus (in Japanese with English abstract). Acta Anat Nippon 71:92–105PubMedGoogle Scholar
  3. Covey AM, Brody LA, Maluccio MA, Getrajdman GI, Brown KT (2002) Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients. Radiology 224:542–547PubMedCrossRefGoogle Scholar
  4. Honma S, Tokiyoshi A, Kawai K, Koizumi M, Kodama K (2008) Radial artery running beneath the biceps tendon and its interrelation between the radial recurrent arteries. Anat Sci Int 83:232–238PubMedCrossRefGoogle Scholar
  5. Kawai K, Honma S, Koizumi M, Kodama K (2008) Inferior epigastric artery arising from the obturator artery as a terminal branch of the internal iliac artery and consideration of its rare occurrence. Ann Anat 190:541–548PubMedCrossRefGoogle Scholar
  6. Lippert H, Pabst R (1985) Arterial variations in man. Bergmann, Munich, pp 32–33CrossRefGoogle Scholar
  7. Michels NA (1955) Blood supply and anatomy of the upper abdominal organs. Lippincott, Philadelphia, pp 141–142, 365Google Scholar
  8. Northover JMA, Terblanche J (1979) A new look at the arterial supply of the bile duct in man and its surgical implications. Br J Surg 66:379–384PubMedCrossRefGoogle Scholar
  9. Parke WW, Michels NA, Ghosh GM (1963) Blood supply of the common bile duct. Surg Gynecol Obstet 117:47–55PubMedGoogle Scholar
  10. Saba L, Mallarini G (2011) Anatomic variations of arterial liver vascularization: an analysis by using MDCTA. Surg Radiol Anat 33:559–568PubMedCrossRefGoogle Scholar
  11. Skandalakis JE (2004) Skandalakis’ surgical anatomy, vol 2. Paschalidis, Athens, pp 1109–1130Google Scholar
  12. Song SY, Chung JW, Lim HG, Park JH (2006) Nonhepatic arteries originating from the hepatic arteries: angiographic analysis in 250 patients. J Vasc Interv Radiol 17:461–469PubMedCrossRefGoogle Scholar
  13. Strasberg SM, Helton WS (2011) An analytical review of vasculobiliary injury in laparoscopic and open cholecystectomy. HPB (Oxford) 13:1–14CrossRefGoogle Scholar
  14. Suzuki H (1982) Correlation and anomalies of the vascular structure in Glisson’s area around the hepatic hilum, from the standpoint of hepatobiliary surgery. Arch Jpn Chir 51:713–731Google Scholar
  15. Weiglein AH (1996) Variations and topography of the arteries in the lesser omentum in human. Clin Anat 9:143–150PubMedCrossRefGoogle Scholar

Copyright information

© Japanese Association of Anatomists 2012

Authors and Affiliations

  1. 1.Division of Morphological Neuroscience, Department of AnatomyShiga University of Medical ScienceOtsuJapan
  2. 2.Division of Anatomy and Cell Biology, Department of AnatomyShiga University of Medical ScienceOtsuJapan
  3. 3.Neurosensing and Bionavigation Research CenterDoshisha UniversityKyotoJapan

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