The following statement(s) is/are true concerning the relationship of the biliary tree and the hepatic artery and portal vein.
- The common hepatic and common bile duct lie immediately anterior to the portal vein
- The cystic artery, which usually arises from the right hepatic artery, crosses behind the hepatic duct in most cases
- A replaced right hepatic artery arising from the superior mesenteric artery system will run to the right of the common bile duct
- The arterial supply of the extrahepatic biliary ducts is derived from major trunks running along the medial and lateral walls of the common duct at the 3 o’clock and 9 o’clock position
a.The common hepatic and common bile duct lie immediately anterior to the portal vein
b.The cystic artery, which usually arises from the right hepatic artery, crosses behind the hepatic duct in most cases
c.A replaced right hepatic artery arising from the superior mesenteric artery system will run to the right of the common bile duct
d.The arterial supply of the extrahepatic biliary ducts is derived from major trunks running along the medial and lateral walls of the common duct at the 3 o’clock and 9 o’clock position
The common hepatic duct passes downward in the superior and lateral portions of the hepatoduodenal ligament and lies in front of the portal vein and to the right of the hepatic artery. The cystic artery which in most cases arises from the right hepatic artery usually crosses behind the hepatic duct (84%) of cases but is sometimes anterior to that structure (16%) of cases. A number of anatomic variations of the arterial supply of the liver can be seen. In patients in which the right hepatic artery arises from the superior mesenteric artery system, the "replaced" right hepatic artery usually runs to the right of the bile duct and portal vein. The arteries to the extrahepatic biliary ducts anastomose freely within the duct walls. The ductal arterial supply is derived primarily from the gastroduodenal and right hepatic arteries with major trunks running along the medial and lateral walls of the common duct at the 3 o’clock and 9 o’clock positions.
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