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Evaluation of celiac artery and common hepatic artery variations by CT-angiography and new classification model

  • Anatomic Variations
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Abstract

Purpose

Knowledge of anatomical variations is important in all interventional procedures. This study aims to evaluate the variations and prevalence of celiac trunk (CeT) and its branches.

Methods

The computerized tomography-angiography (CT-A) findings of 941 adult patients were evaluated retrospectively. Variations of the CeT and common hepatic artery (CHA) were evaluated according to the number of branches and their origin. Findings were compared with classical classification methods. A new classification model has been defined.

Results

Normal (complete) trifurcation was detected in 856 (90.9%) of them, where left gastric artery (LGA), splenic artery (SpA) and CHA branches were derived from the CeT. Among 856 complete trifurcation cases, 773 (90.3%) had non-classical trifurcation patterns. The rate of classic trifurcation was 8.8%, while non-classic trifurcation was 82.1% in all cases. In one case (0.1%), LGA and left hepatic artery together and right hepatic artery and SpA together appeared as a double bifurcation. Complete celiacomesenteric trunk was observed only in 4 (0.42%) cases. In seven cases (0.7%), LGA, SpA and CHA were coming out of abdominal aorta (AAo) independently. CHA normal anatomy (Michels Type I) was detected in 618 (65.5%) patients. We found that 49 (5.2%) of our cases were ambiguous according to the Michels Classification. We have described five different variations of hepatic arteries directly arising from the AAo.

Conclusion

Preoperative recognition of anatomical variations of CeT, superior mesenteric artery and CHA is of primary importance in both surgical and radiological procedures. With careful evaluation of CT-angiographies, it is possible to detect rare variations.

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Please contact corresponding authors for data requests. The data are not publicly available due to privacy or ethical restrictions.

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Funding

The authors did not receive funding from any organization for the submitted work.

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Authors and Affiliations

  1. Department of General Surgery, Trakya University Medical Faculty, 22030, Edirne, Turkey

    Zeliha Türkyılmaz & Tuğrul Demirel

  2. Department of Radiology, Trakya University Medical Faculty, 22030, Edirne, Turkey

    Osman Kula, Ahmet Onur Çelik & Burak Günay

Authors
  1. Zeliha Türkyılmaz
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  2. Osman Kula
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  3. Ahmet Onur Çelik
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  4. Tuğrul Demirel
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  5. Burak Günay
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Contributions

ZT project development, data analysis, manuscript writing. OK project development, data collection. AOC data collection. TD data analysis, manuscript editing. BG data collection.

Corresponding author

Correspondence to Zeliha Türkyılmaz.

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Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

This study has been carried out in accordance with the standards set out in the Code of Ethics of the World Medical Association (Declaration of Helsinki). This retrospective study was approved by Trakya University Clinical Research Ethics Committee (12/22, 31.05.2021). Informed consent was obtained from all patients. Appropriate permission was obtained for the CT-Angiography images of the patients.

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Türkyılmaz, Z., Kula, O., Çelik, A.O. et al. Evaluation of celiac artery and common hepatic artery variations by CT-angiography and new classification model. Surg Radiol Anat 45, 1037–1047 (2023). https://doi.org/10.1007/s00276-023-03180-1

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