title: Anomalous arterial ramification in the right liver.
abstract: OBJECTIVE
  The aim of this study was to investigate whether individual arterial and portal venous division during hepatectomy is always safe by examining the presence of the anomalous arterial ramification in the right liver.
  
  
  METHODS
  The ramifications of the right hepatic artery (RHA) were investigated by three-dimensional (3D) reconstruction imaging using a computer software program in 87 patients undergoing computed tomography during angiography as a preoperative assessment of intrahepatic tumors.
  
  
  RESULTS
  The anterior view showed that the RHA bifurcated into the anterior and posterior sector arteries at the hilum in 76 patients. Sector-intersecting arteries from the posterior to the anterior sector and vice versa were found in 7 and 4 of those patients, respectively. The RHA in the other 11 patients was divided in a complex manner into more than 2 arteries: e.g., the first branch to the cranial part of the posterior sector, the second to the anterior sector, and the third to the caudal part of the posterior sector. A total of 22 patients showed anomalous ramification of RHA.
  
  
  CONCLUSIONS
  Preoperative observation of the hepatic artery by 3D imaging is very useful to detect anomalous ramification. Arterial dissection during the intrafascial approach should be cautiously performed based on the 3D images.
authors.affiliation: Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan, saka1119@hama-med.ac.jp.
authors.forename: Takanori
authors.initials: T
authors.lastname: Sakaguchi
authors.forename: Shohachi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Takanori
authors.initials: T
authors.lastname: Hiraide
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shibasaki
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Morita
authors.forename: Atsushi
authors.initials: A
authors.lastname: Suzuki
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Fukumoto
authors.forename: Keisuke
authors.initials: K
authors.lastname: Inaba
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Takehara
authors.forename: Hatsuko
authors.initials: H
authors.lastname: Nasu
authors.forename: Mika
authors.initials: M
authors.lastname: Kamiya
authors.forename: Shuhei
authors.initials: S
authors.lastname: Yamashita
authors.forename: Takasuke
authors.initials: T
authors.lastname: Ushio
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006499:Hepatic Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008099:Liver / Q000098:blood supply*; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D009389:Neovascularization, Pathologic; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000601:surgery; D057234:Preoperative Period