Replaced Left Hepatic Artery: Clinical Significance and Review of the Literature

Purpose: Knowledge of hepatic arterial variations is important for surgeons and interventional radiologists in various hepatic interventions, not only for appropriate planning but also to prevent complications. Incidence of hepatic arterial variations is high, however replaced left hepatic artery is a rare variant. Methods: We conducted a retrospective review of 400 abdominal CT scans of patients referred to our department for various etiologies over a period of one year excluding patients referred for post-operative evaluation of hepato-biliary, stomach or pancreatic malignancies and post-transplant patients. Results: Our study population comprised of 222 males (55.5 %) and 178 females (44.5 %) with age range of 18-78 years. We found 20 cases [14 males (70 %) and 6 females (30 %)] of replaced left hepatic artery (age range: 23-62 years; mean- 42.2 + 11.2 years). An associated replaced right hepatic artery was noted in one patient (5 %). Conclusion: Replaced left hepatic artery, though rare, is a variation in hepatic arterial branching pattern which has to be reported to prevent untoward event in surgical or interventional radiology procedures.