Gross Anatomical Variations in the Branching Patterns of the Hepatic Artery and Portal Vein in Adult Human Livers

Abstract

Objective: To describe hepatic arterial and portal venous branching patterns in adult human livers examined at autopsy in three teaching hospitals of Lahore.

Materials and methods: This multicenter descriptive anatomical study conducted from july 2024 to December 2025 and included 60 adult autopsy cadavers. The hepatic arteries were traced from their parent vessels to the porta hepatis, and the main and right portal veins were examined for their major branches. Replaced and accessory arteries were distinguished by the absence or presence of the usual artery supplying the same territory. Branching patterns were recorded as frequencies and percentages. The coexistence of arterial and portal venous variants was also described.

Results: Classic hepatic arterial branching was recorded in 36 specimens (60.0%), and arterial variants were found in 24 (40.0%). A replaced right hepatic artery arising from the superior mesenteric artery was the most frequent arterial variant (10/60, 16.7%). Classic portal venous branching was recorded in 42 specimens (70.0%). The commonest portal variant was trifurcation of the main portal vein (7/60, 11.7%), followed by a right posterior portal branch arising directly from the main portal vein (5/60, 8.3%). Nine specimens (15.0%) had variants in both vascular systems.

Conclusion: Hepatic arterial and portal venous branching showed appreciable variation in this autopsy series. Describing the origin and course of each vessel provided a clearer anatomical account than assigning a classification label alone. Knowledge of these patterns remained relevant to anatomical teaching and planning hepatobiliary procedures.