ANATOMICAL VARIATIONS OF HEPATIC ARTERIAL AND PORTAL VENOUS SYSTEM IN NORTH INDIAN CADAVERS : A CADAVERIC STUDY WITH SURGICAL CORRELATION

Abstract

Background: The clinical stakes are high in hepatobiliary surgery, liver and pancreatic operations, as well as interventional radiology, given the frequency of anatomical variations in the hepatic arterial and portal venous systems. An exact understanding of such variations is what allows for better surgical results and the avoidance of vascular damage.

Materials and Methods: We carried out a descriptive observational study on cadavers at the Department of Anatomy of the Saraswathi Institute of Medical Sciences in Hapur, Uttar Pradesh, over the period from 10th October 2024 to 31st January 2026. Standard dissection techniques were applied to 50 adult human specimens (30 of them male, 20 female) that had intact hepatobiliary anatomy. The branching and origin of the portal vein and hepatic arteries were recorded. For classification purposes, we used Michels and Hiatt for the hepatic arteries and Cheng’s system for the portal vein. All data was put through SPSS version 26.0 for analysis.

Results: In 90% of the specimens (45 cases), the common hepatic artery originated from the celiac trunk, while 3 specimens (6%) and 2 specimens (4%) demonstrated an origin from the superior mesenteric artery and the left gastric artery, respectively. According to the Michels classification, 28 specimens (56%) exhibited normal Type I hepatic arterial anatomy, whereas the remaining 22 specimens (44%) showed anatomical variations. These included replaced right hepatic artery in 5 specimens (10%), replaced left hepatic artery in 5 specimens (10%), accessory right hepatic artery in 5 specimens (10%), accessory left hepatic artery in 2 specimens (4%), common hepatic artery arising from the superior mesenteric artery in 2 specimens (4%), and common hepatic artery arising from the left gastric artery in 3 specimens (6%). Regarding the portal vein, 30 specimens (60%) demonstrated the typical bifurcation pattern, while the remaining 20 specimens (40%) exhibited anatomical variations, including portal vein trifurcation in 10 specimens (20%), early branching in 8 specimens (16%), and a separate segment VI branch in 2 specimens (4%).

Conclusion: These are not uncommon findings and carry weight in any surgical or radiological context. To get the best outcome and limit complications in procedures ranging from interventional work to transplantation, it is imperative to have these vascular patterns identified before the operation. We would advocate for more extensive multicentric research to establish how prevalent these variations are across various populations.