Overview

Gastroduodenal artery. This runs down behind the first part of the duodenum. It gives the right gastro-omental artery, which follows the greater curvature, and the superior pancreaticoduodenal arteries.

Proper hepatic artery. This ascends in the free edge of the lesser omentum (the hepatoduodenal ligament). Within the ligament the common bile duct lies to its right and the portal vein lies behind both. The right gastric artery usually arises from it. At the porta hepatis it divides into the right and left hepatic arteries. The right hepatic artery usually gives off the cystic artery inside the hepatobiliary (Calot) triangle.

Contribution to the liver. The hepatic artery provides only about 25–30% of the liver's blood flow but about half of its oxygen. The bile ducts depend entirely on hepatic arterial blood.

Anatomy

Branches: The gastroduodenal artery, which gives the right gastro-omental and superior pancreaticoduodenal arteries, and the proper hepatic artery, which gives the right gastric artery and the right and left hepatic arteries. The cystic artery usually comes from the right hepatic artery.

Function

Supplies oxygenated blood to the liver, gallbladder and bile ducts.
Supplies the pylorus, duodenum and head of pancreas through the gastroduodenal artery.

Clinical significance

Posterior duodenal ulcer

An ulcer on the back wall of the first part of the duodenum can erode the gastroduodenal artery and cause massive bleeding: vomiting of blood or black, tarry stools.

Pringle manoeuvre

Clamping the hepatoduodenal ligament through the epiploic foramen stops inflow through both the hepatic artery and the portal vein. This controls bleeding from the liver during trauma surgery or liver resection.

Arterial variants and cholecystectomy

In about 10–20% of people the right hepatic artery arises from the SMA instead (a replaced right hepatic artery). The cystic artery is found inside Calot's triangle. During cholecystectomy, surgeons must achieve the "critical view of safety" before dividing anything, to avoid injuring the arteries or bile ducts.

Hepatic artery thrombosis after liver transplant

After liver transplantation the bile ducts depend entirely on the hepatic artery. If it thromboses, the ducts become ischaemic and the graft is at risk.

Compiled from standard anatomy and physiology references — see the Cardiovascular System sources. For education only; not medical advice.