Optimal branching of hepatic artery in patients with chronic viral diseases

Abstract

Utilizing the optimal principle of branching structure, the author determined how the branching structure of hepatic arterial vessels changed in chronic viral liver disease as liver surface lesions progressed. A total of 47 patients, including 33 subject patients diagnosed as having a chronic viral liver disease on laparpscopy and 14 control patients without liver disfunction, were examined. Diameters of the parent artery and its branches at the bifurcation of the third branch from the anterior branch of the right hepatic artery were measured on celiac arteriogram. Branching angles of these branches were estimated from branching angles of portal veins measured at the same branch-point by ultrasonography. In each patient, degrees of discrepancies in vessel diameters and branching angle between actual values and theoretical values, which satisfied the optimal principle, were determined according to Zamir's method. Although values representing the relationship between vessel diameters before and after bifurcation did not differ between the control and chronic liver disease groups, actual branching angles of hepatic arterial vesseles became gradually dissociated from theoretical values at level code No.300 according to Shimada's classification on laparoscopic changes of liver surface among the chronic liver disease, and there were remarkable discrepancies found at level code Nos. 400 and 500, suggesting a decrease in energy efficiently of hepatic arterial circulation.