The blood supply of the hilar bile duct and its relationship to the communicating arcade located between the right and left hepatic arteries.
BACKGROUND
There is an increasing demand for living donor liver transplants. However, the biliary complication rates are still high.


METHODS
The anatomy of the communicating arcade (CA) between the right and left livers and its relevance to the blood supply of the hilar bile duct was evaluated using adult cadaveric livers and cast specimens.


RESULTS
In all specimens that were of sufficient quality for evaluation, the CA was found to be located extrahepatically in the hilar plate with thin tributaries branching to the hilar bile duct. On the left side, 55% of the CA originated from a segment IV artery. On the right side, 73% of the CA originated from the right anterior hepatic artery.


CONCLUSIONS
To maintain an adequate blood supply for the hilar bile duct of the donor graft during living donor liver transplantation, the branching point of the CA should be preserved.
Gunji
Hisashi
H
Department of Academic Surgery, Chiba University Graduate School of Medicine, and Department of Surgery, Chiba Cancer Center Hospital, Japan. hgunjijp@yahoo.co.jp
Cho
Akihiro
A
Tohma
Takayuki
T
Okazumi
Shinichi
S
Makino
Harufumi
H
Shuto
Kiyohiko
K
Mochizuki
Ryouyu
R
Matsubara
Katsuhiko
K
Hayano
Kouichi
K
Mori
Chisato
C
Murakami
Gen
G
Ochiai
Takenori
T
D000328:Adult; D001652:Bile Ducts / Q000098:blood supply*; D002102:Cadaver; D016319:Corrosion Casting; D004210:Dissection; D006499:Hepatic Artery / Q000033:anatomy & histology*; D006801:Humans; D008099:Liver / Q000033:anatomy & histology*