THE VARIANT ANATOMY OF THE CELIAC TRUNK AND ITS BRANCHES IN ADULT MEN AND WOMEN WITH VARIOUS BODY SHAPE

In connection with the rapid development of endovascular surgery and the increasing number of minimally invasive surgeries there is a need for a detailed study of variants of the architectonic and topographic and anatomical characteristics of extraorganic blood vessels. The purpose of the study was to study the variant anatomy of the celiac trunk and its branches in adult men and women with different shapes of body. The analysis of 2300 computer tomograms of the abdominal aorta and its unpaired branches of adult men and women in age 25-75 years with a different body type was made. According to the value of the Pinier index, were dedicated asthenic, normosthenic and hypersthenic forms of the physique. It is established that the cases of a typical classic variant of celiac trunk trifurcation in men is observed only in 35% of cases, and in women – in 41.2%, with an atypical variant of its division was observed significantly more often (in 65 and 58,8%, respectively). It is shown that regardless of gender and the shape of the body at Pinier index in all studied groups, the incidence of typical branching of the celiac trunk varies from 32.1 to 49.4%, and the frequency of atypical variant is an average of 62.1%. Among atypical variants of division of the celiac trunk quadrifurcation occurs more often. Thus, the frequency of most of the variants of the celiac trunk showed significant differences depending on gender and body type. Knowledge of variant anatomy of the celiac trunk will be may significantly increase the quality of preoperative diagnosis in surgery on the celiac trunk and its branches, and exclude iatrogenic damage of these vessels.

1. Antropova EG, Jakimov AA. Krovosnabzhenie pecheni iz sistem chrevnogo stvola i verhnej bryzheechnoj arterii (opisanie sluchaja). Uchjonye zapiski SPBGMU im. Akad. I.P. Pavlova. 2011; 18(2):23.

2. Patjutko JuI, Sajdak IV. Puti uluchshenija perenosimosti gastropankreatoduodenal'noj rezekcii. Hirurgija. 2002;(10):29–32.

3. Chen RF, Huang CM, Chen QY. Why the proximal splenic artery approach is the ideal approach for laparoscopic suprapancreatic lymph node dissection in advanced gastric cancer? A large-scale vascular-anatomical-based study. Medicine. 2015;94(18):832.

4. Kalandarishvili MO. Klinicheskaja anatomija selezenochnoj arterii i veny. Morfologicheskie Vedomosti – Morphological Newsletter. 2007;1(2):278–280.

5. Ogino T, Takemasa I, Horitsugi G. Preoperative evaluation of venous anatomy in laparoscopic complete mesocolic excision for right colon cancer. Annals of surgical oncology. 2014;(21):429–435.

6. Pinal-Garcia DF, Nuno-Guzman CM, Gonzalez-Gonzalez ME, Ibarra-Hurtado TR. The celiac trunk and its anatomical variations: a cadaveric study. Journal of Clinical Medicine Research.

7. ;10(4):321–329.

8. Selvaraj L, Sundaramurthi I. Study of normal branching pattern of the coeliac trunk and its variations using CT angiography. J. of Clinical and Diagn. Research. 2015;9(9):1–4.

9. Tiwari S, Jeyanthi K. Study of origin of inferior phrenic arteries from the celiac trunk. Anatomica Karnataka. 2012;6(3):38–41.

10. Song SY. Celiac axis and common hepatic artery variations in 5002 patients: systematic analysis with spiral CT and DSA. Radiology. 2010;255(1):278–288.

11. Gajvoronskij IV, BN Kotiv, Kovalenko NA, Pelipas' JuV, Gorjacheva IA, Fandeeva OM . Variantnaja anatomija chrevnogo stvola, ego magistral'nyh i aberrantnyh vetvej. Morfologija.

12. ;154(4):27-33.

13. Malnar D. Anatomical properties of the celiac trunk. Coll. Antropol. 2010;34(3):917–921.

14. Michels NA. The hepatic, cystic and retro duodenal arteries and their relations to the biliary duct. Ann. Surg. 1951;(133):503–524.

15. Pushpalatha K, Deepa B, Shama SNM. A study of anatomical variations in the origin, length and branches of celiac trunk and its surgical significance. Int. J. Anat. Res. 2016;4(1):1781–1788.

16. Tandler J. Uber die Varietaten der Arteria coeliaca und deren Entwicklung. Anat Hft.

17. ;(25):472–500.

18. Venieratos D. A morphometric study of the celiac trunk and review of the literature. D. Venieratos Clin. Anat. 2013;(26):741–750.

19. Badagabettu S., Padur A., Kumar N., Reghunathan D. Absence of the celiac trunk and trifurcation of the common hepatic artery: a case report. J. Vasc. Bras. 2016;15(3):259–262.

20. Alsabilah JF, Razvi SA, Albandar MH, Kim NK. Intraoperative archive of right colonic vascular variability aids central vascular ligation and redefines gastrocolic trunk of Henle variants. Dis. Colon Rectum. 2017;60(1):22–29.

21. Saritha S, Jyothi N, Kumar M, Supriya G. Cadaveric study of accessory renal arteries and its surgical correlation. International Journal of Research in Medical Sciences. 2017;1(1):19–22.

22. Petrella S, Rodriguez C, Sgrott E. Origin of inferior phrenic arteries in the celiac trunk. Int. J. Morphol. 2006;24(2):165.

23. Gielecki J, Zurada A, Sonpal N, Jaboska B. The clinical relevance of coeliac trunk variations. Folia Morphol. (Warsz). 2005;64(3):123–129.

24. Kovalenko NA. Variantnaja anatomija vetvej chrevnogo stvola, kornej i pritokov vorotnoj veny i ee prikladnoe znachenie v hirurgii gastrosplenopankreatoduodenal'noj zony: diss. … kand. med. nauk. SPb. 2019:172.