Hepatolithiasis caused by right hepatic artery branches forming an arterial ring compressing the common hepatic duct

Anatomic variations of the hepatic artery do not usually cause biliary obstruction. We present a 51-year-old male who developed biliary obstruction and hepatolithiasis due to extrinsic compression of the common hepatic duct (CHD) by an arterial ring formed by the anterior and posterior branches of the right hepatic artery. We performed a surgical bile duct exploration and used intraoperative direct cholangioscopy to guide clearance of hepatolithiasis. Herein, we review the existing literature on CHD compression caused by topographical variants of the hepatic artery and discuss diagnostic and treatment strategies.

Automated summary

Anatomic variations of the hepatic artery can lead to biliary obstruction, although the incidence is low. In this study, we report a case of biliary obstruction and hepatolithiasis caused by extrinsic compression of the common hepatic duct by an arterial ring formed by the anterior and posterior branches of the right hepatic artery. We review the existing literature on this topic and discuss diagnostic and treatment strategies.