The common hepatic artery, after entering the hepatic duodenal ligament, divides into three branches: the original hepatic artery, the gastroduodenal artery, and the right gastric artery. Among them, the original hepatic artery rises again on the inner edge of the hepatic duodenal ligament to the left of the gallbladder, and divides into left and right branches at the periphery of the hepatic portal to enter the liver. At the starting and ending parts of the original hepatic artery, the right gastric artery also emanates, enters the lesser curvature of the stomach to the left through the upper part of the esophageal opening, and converges with the left gastric artery. The right branch of the original hepatic artery exits the gallbladder artery to various parts of the gallbladder.

The hepatic trunk aorta is transmitted from the celiac trunk, and after entering the hepatoduodenal ligament, it divides into the hepatic original aorta, the gastroduodenal aorta, and the right gastric aorta. Among them, the hepatic original aorta rises along the hepatoduodenal ligament and divides into the left hepatic artery and the right hepatic artery through the first hepatic portal into the liver. The right gastric aorta runs to the left after being emitted, and conforms to the left gastric aorta. The gastroduodenal aorta divides into the right gastric retinal artery and the superior pancreatoduodenal artery, respectively, and conforms to the left gastric retinal artery and the inferior pancreatoduodenal artery.

The hepatic trunk aorta branch is generally referred to as the hepatic original aorta after separating from the gastroduodenal artery, which is commonly known in clinical medicine as GDA. GDA has great clinical significance. Generally, when we perform pancreatoduodenectomy surgery, the ligation of GDA must be firm and close to the root, to avoid postoperative GDA infection and bleeding, leading to patient hemorrhagic death. Normally, in imaging diagnosis, we determine whether the tumor can be completely resected by understanding whether GDA has tumor infiltration. If there is an abnormality in the GDA of the hepatic trunk aorta branch, there may be vascular genetic variation, which is conducive to guiding our operation in surgery. Some patients with significant genetic variations in the hepatic trunk aorta and GDA can be reconstructed in three dimensions, understanding the distribution and position of the liver aorta branch, which is also conducive to guiding our surgical treatment.

The hepatic trunk aorta is one of the three main branches of the abdominal aorta. As a very important branch originating from the abdominal aorta, it is transmitted from the abdominal aorta to the hepatic trunk aorta. The right gastric aorta and the gastroduodenal aorta sequentially separate above the first part of the duodenum, and generally more than 40% of liver disease patients can detect anatomical genetic variations in part of the hepatic trunk aorta.

The necessity of the hepatic trunk aorta

After birth, humans generally retain one aorta, and the subsequent development of the aorta is mainly derived from the abdominal aorta. Generally, the left hepatic artery and the right hepatic artery separate, supplying normal blood and CO2 to the left and right liver. The distribution and transformation of the hepatic trunk aorta are very important for imaging of the abdominal aorta or hepatic artery. The blood supply of the hepatic trunk aorta accounts for about 25% of the total liver blood supply, with an oxygen concentration of about 50%. In addition, sometimes it is possible to see the aorta emitted from the left gastric aorta or the superior mesenteric aorta.

However, the coexistence of the abdominal aorta and the left gastric aorta originating from the abdominal aorta, as well as the two aortas originating from the superior mesenteric aorta, is generally very rare. The hepatic artery originating outside the abdominal aorta is called the sympathetic hepatic artery. If the hepatic artery originates from the aorta other than the abdominal aorta, the source of the hepatic artery disorder is called replacement aorta. Hepatic transplant surgeons must have a thorough understanding of the distribution and genetic variation of the hepatic trunk aorta, which is crucial for vascular compatibility in the acquisition of donor liver and in the middle and later stages of heart transplantation surgery.