Preliminary Cadaveric Study of Branching Pattern of the Coeliac Trunk in a Selected Sri Lankan Population

Abstract

Coeliac trunk is the first central branch from abdominal aorta giving rise to its 3 main branches; Left Gastric (LGA), plenic (SA) and Common hepatic (CHA) artery. Sri Lankan studies on celiac trunk anatomical variations are scarce. Morphology of coeliac trunk and its branches are important in development of techniques for liver transplantation and gall bladder surgeries. The objective of the present study was to describe the morphology of coeliac trunk and main branches in a selected Sri Lankan population. Eleven formalin fixed adult cadavers were dissected and measurements were taken by using electronic digital caliper. Majority [54.5% (6/11)] of the coeliac trunks originating closer to the upper border of 1st lumbar vertebral body. Percentage72.7 (8/11) of coeliac trunks divides in to normal 3 main branches while 27.3 % (3/11) had additional left and right inferior phrenic arteries as the first branches. Majority [45.5% (5/11)] LGA originated within 0.5cm from the origin of the trunk. Majority of right gastric artery [45.5% (5/11)] arises from the gastro duodenal artery while in 18.5% (2/11) had it from the hepatic artery proper. In majority [36.4% (4/11)] all 3 branches were given as terminal branches 27.3% (3/11) gave SA and CHA as terminal branches 0.5cm distal to the origin of LGA. All the proper hepatic arteries were raised from CHA while 40% (4/11) were located anterior and 40% (4/11) were medial to the common bile duct. Presentage 81.8 % (9/11) had cystic artery originating from the right hepatic artery with gender distribution of 1:2 of male:Famale respectively, while 11.2% (2/11) gave it from the gastro-duodenal artery with equal gender distribution. Percentage 54.5 (6/11) cystic arteries have passed anterior to the cystic duct. Branching pattern of the coeliac trunk was similar to western studies with anatomical variations. More cadaveric studies are needed to develop Sri Lankan data base.