TTP6.14 Aberrant Right Hepatic Artery: A Common Anomaly Requiring Awareness during Laparoscopic Cholecystectomy

Background The aberrant right hepatic artery (ARHA) is an anatomical variation of the hepatic vasculature, present in up to 25% of the population. Laparoscopic cholecystectomy is a core procedure for final certification in general surgery. This case series highlights the frequency of ARHA and emphasizes the importance of intraoperative awareness. Case Presentations Over a three-month period, four cases of ARHA were encountered during laparoscopic cholecystectomy, performed by resident doctors under the direct supervision of the same surgeon. In each case, ARHA was suspected intraoperatively due to the presence of an unusually large vessel crossing Calot’s triangle. Careful dissection of the ARHA from the gallbladder to the liver was performed, along with clipping of the cystic artery at its high origin. All surgeries were completed uneventfully, and patients were advised to undergo a CT angiogram for future reference of their vascular anatomy. Discussion The term "aberrant" refers to an artery located unusually, but does not specify whether it is a replacement artery providing sole blood supply or an accessory artery. ARHA can arise from the superior mesenteric, common hepatic, or right hepatic artery. In our cases, it originated either medially or inferiorly. ARHA's presence is crucial in hepatobiliary and pancreatic surgeries, as it is vulnerable during laparoscopic cholecystectomy. If undetected, ligation of the ARHA can lead to significant vascular complications. Conclusion ARHA is a common anatomical variation, and its recognition during laparoscopic cholecystectomy is critical to avoid vascular injury. Surgeons must maintain awareness and employ careful dissection techniques to prevent complications