Aberrant right posterior hepatic artery originating from the gastroduodenal artery with a concomitant replaced left hepatic artery: a rare clinical variant

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Obstructive jaundice due to a pancreatic head mass with an aberrant right posterior hepatic artery from the gastroduodenal artery and a replaced left hepatic artery (n=1). Intervention: Pancreaticoduodenectomy (Whipple procedure) with preservation of aberrant right posterior hepatic artery. Primary outcome: Vascular complications and postoperative hepatic perfusion deficits.

Murat Emre Reis; Yavuz Selim Angın; Orxhan Ulfanov; Murat Ulas; Mehmet Kılıç; Elif Gündoğdu

doi:10.1007/s00276-025-03814-6

January 29, 2026Surgical and Radiologic AnatomyOpen Access

Aberrant right posterior hepatic artery originating from the gastroduodenal artery with a concomitant replaced left hepatic artery: a rare clinical variant

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Key result

Preoperative CTA and careful dissection preserve aberrant hepatic arteries during pancreaticoduodenectomy without vascular complications.

n=1

Key Points

To describe an extremely rare hepatic arterial variant involving an aberrant right posterior hepatic artery originating from the gastroduodenal artery alongside a replaced left hepatic artery.
Evaluated a 57-year-old male presenting with obstructive jaundice secondary to a pancreatic head mass using axial CT angiography and 3D reconstructions.
Conducted a pancreaticoduodenectomy with targeted identification and preservation of the aberrant hepatic branch prior to gastroduodenal artery ligation.
Preoperative vascular mapping revealed an aberrant right posterior hepatic artery branching directly from the gastroduodenal artery and a replaced left hepatic artery originating from the left gastric artery.
The aberrant right posterior hepatic artery was preserved intraoperatively, resulting in successful pancreaticoduodenectomy with no postoperative vascular complications or hepatic perfusion deficits.

Study Design

Type

Case Report (n=1)

Multicenter

No

PICO

P

Population

1 male patient aged 57 years presenting with obstructive jaundice due to a pancreatic head mass and dual hepatic arterial variations undergoing pancreaticoduodenectomy.

I

Intervention / Comparator

Pancreaticoduodenectomy (Whipple procedure) with preservation of aberrant right posterior hepatic artery

O

Primary Outcome

Vascular complications and postoperative hepatic perfusion deficits

Limitations

Single clinical case report
Lack of large-scale statistical data on this specific dual variation limits the ability to predict its prevalence across different ethnic populations

Implication

Describes a rare hepatic artery variant, highlighting its importance in pancreaticoduodenectomy, suggesting implications for surgical practices.

Abstract

Variations in the hepatic arterial system, observed in up to 22% of the population, significantly influence the outcomes of hepatobiliary and pancreatic procedures. This study describes an extremely rare variant involving an aberrant right posterior hepatic artery (aRPHA) originating from the gastroduodenal artery (GDA) alongside a replaced left hepatic artery (LHA). Awareness of such variants is critical during pancreaticoduodenectomy to prevent ischemic complications.

Discussion

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Cite This Study

Reis et al. (2026) conducted a case report in Obstructive jaundice due to a pancreatic head mass with an aberrant right posterior hepatic artery from the gastroduodenal artery and a replaced left hepatic artery (n=1). Pancreaticoduodenectomy (Whipple procedure) with preservation of aberrant right posterior hepatic artery was evaluated on Vascular complications and postoperative hepatic perfusion deficits. Preoperative CT angiography and careful surgical dissection during pancreaticoduodenectomy preserved an aberrant right posterior hepatic artery from the GDA with 0% vascular complications.

synapsesocial.com/papers/6980fd18c1c9540dea80ed21 https://doi.org/10.1007/s00276-025-03814-6

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Aberrant right posterior hepatic artery originating from the gastroduodenal artery with a concomitant replaced left hepatic artery: a rare clinical variant

Key Points

Study Design

PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Aberrant right posterior hepatic artery originating from the gastroduodenal artery with a concomitant replaced left hepatic artery: a rare clinical variant

Key Points

Study Design

PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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