Origin of the Right Gastric Artery
The right gastric artery most commonly originates from the proper hepatic artery, with a pooled prevalence of 53.6% according to the most recent systematic review and meta-analysis. 1
Common Origins of the Right Gastric Artery
The right gastric artery typically originates from one of several sources, with varying frequencies:
- Proper Hepatic Artery (PHA): 53.6% of cases 1
- Left Hepatic Artery (LHA): 25.9% of cases 1
- Gastroduodenal Artery (GDA): 8.89% of cases 1
- Common Hepatic Artery (CHA): 6.86% of cases 1
- Right Hepatic Artery (RHA): 3.43% of cases 1
- Middle Hepatic Artery (MHA): 1.31% of cases 1
Clinical Significance
Understanding the origin of the right gastric artery is important in several clinical contexts:
- During gastric cancer surgery, particularly when performing D1 or D2 lymphadenectomy, as the suprapyloric lymph nodes (station 5) are located along the first branch and proximal part of the right gastric artery 2
- When performing transarterial chemoembolization procedures, where knowledge of vascular anatomy is critical to avoid complications 2
- During hepatobiliary surgery, where variant anatomy may increase risk of iatrogenic injury 3
Anatomical Variations
Several notable variations have been documented in the literature:
- The right gastric artery may occasionally form from a common trunk with the supraduodenal artery originating from the left hepatic artery 4
- In rare cases, double right gastric arteries may be present, forming an arterial loop 5
- The right gastric artery may be hypoplastic in some cases when originating from the gastroduodenal artery 3
Historical Context
Early anatomical studies from the 1980s identified the proper hepatic artery as the most common origin (approximately 53%), which is consistent with modern findings 6. This demonstrates the consistency of this anatomical pattern across different populations and time periods.
Practical Implications
Knowledge of these variations is essential for:
- Surgeons performing gastric resections with lymphadenectomy 2
- Interventional radiologists performing hepatic arterial infusion chemotherapy 4
- Transplant surgeons during liver transplantation procedures 3
- Accurate interpretation of angiographic studies 2
Understanding the most common origin (proper hepatic artery) and being aware of potential variations helps reduce procedure time, radiation exposure, and the risk of iatrogenic complications during surgical and interventional procedures.