Common hepatic artery

Course

• Passes over upper border of pancreas
• Then downwards and to the right behind the peritoneum of the posterior abdominal wall (in the lesser sac) as far as the first part of the duodenum
• Turns forward at the opening into the lesser sac (epiploic foramen) and turns upwards into the space between the 2 layers of the lesser omentum
• Becomes the hepatic artery
  • Meets the bile duct
    • Lies on left side of bile duct
  • Both bile duct and hepatic artery are in front of the portal vein
  • All 3 lie between duodenum and porta hepatis surrounded by peritoneum at free edge of lesser omentum
  • NOTE:
    • Last anatomy states - ‘Common hepatic’ becomes ‘hepatic proper’ as soon as it turns UPWARDS
      • Last also states “The right gastric artery leaves the common hepatic as it turns into the lesser omentum to reach the stomach”
    • Other authors seem to change the name of the artery from common to proper at the point the right gastric leaves the artery

Hepatic artery

• Reaches porta hepatis and divides:
  • Right hepatic artery – right half of liver
  • Left hepatic artery – left half of liver

Other branches

• Right gastric
  • Leaves common hepatic as it turns into lesser omentum to reach the stomach
• Gastroduodenal
  • Passes down behind first part of duodenum to the left of the portal vein
  • Then divides into 2
    • Right gastroepiploic artery
      • Passes forward between first part of duodenum and pancreas
      • Turns to the left to enter between the 2 leaves of the greater omentum at their attachment over the front of the head of the pancreas
    • Superior pancreaticoduodenal artery
      • Divides into 2 branches – encircle the head of the pancreas in the concavity of the duodenum down to the entrance of the bile duct
        • Anterior branch (small)
        • Posterior branch (large)
      • Both branches anastomose with similar branches of the ‘inferior pancreaticoduodenal branch’ (from SMA)
      • Bile duct entrance marks the junction of foregut/midgut – is the meeting place of the arterial distributions of the respective arteries (coeliac/SMA)
      • Pancreaticoduodenal arteries supply:
        • Duodenum
        • Adjacent head of pancreas