Finding the Right Hepatic Artery Branching from the Gastroduodenal Artery in a Patient Undergoing Gastrectomy: A Rare Case of an Anatomical Variant.

Numerous vascular anomalies of the hepatic artery have been reported. Protection of the hepatic arterial supply is important during gastrectomy. We herein report a case in which an anatomical variant of the hepatic artery was discovered in a patient undergoing laparoscopic distal gastrectomy with D1+ lymph node dissection for early gastric cancer. A 50-year-old man was referred to our hospital because of epigastric pain and hematemesis, and he was diagnosed with early gastric cancer after hemostasis of a bleeding ulcer. Computed tomography showed an anatomical variation of the right hepatic artery, which branched from the gastroduodenal artery. Moreover, the right gastric artery branched from the right hepatic artery. Our preoperative understanding of this unusual branch of the hepatic artery enabled safe laparoscopic surgery with adequate lymph node dissection. No postoperative complications occurred. This vascular anomaly has not been previously reported in patients undergoing gastrectomy.