ANATOMICAL VARIATIONS OF THE CELIAC TRUNK: A SYSTEMATIC REVIEW

ABSTRACT Introduction: The celiac trunk (CT) is one of the abdominal portion branches of the aortic artery and, together with the superior mesenteric and inferior mesenteric arteries, participates in the abdominal viscera vascularization through a series of anastomoses. Absence of CT or variation in the number of terminal branches implies in varied abdominal arteries origins, which may have implication in surgical approaches. Objective: To analyze the anatomical variations of the celiac trunk and possible associated surgical clinical implications. Methods: It is a systematic review of articles indexed in the PubMed, Lilacs, SciELO, Springerlink, Scienc Direct and Latindex databases from August to September 2017. Original articles involving the anatomical variations of the celiac trunk in humans were included. The presence/absence of the celiac trunk, the number of terminal branches and the place of origin of its branches in variant cases of the normal anatomical pattern, were considered for this study. Results: At the end of the research, 12 articles were selected, characterized by sample, anatomical structure evaluation method and main results. The normal anatomical pattern was the most prevalent in most studies (75.0%). CT was absent in 41.7% of the findings. The most prevalent anatomical variation was the presence of CT with bifurcation (66.7%). It was also observed the origin of the common and splenic hepatic arteries from the mesenteric arteries (25.0%). The presence of only one branch (16.7%) and quadrifurcation (8.33%) were other findings. Conclusion: CT variations are not uncommon findings, with different anatomic variants being reported. Thus, the importance of knowing the possible variations of this structure is emphasized, which may have implications for surgical interventions and imaging studies related to the abdominal region.

摘要
引言：腹腔干（celiac trunk, CT）是腹主动脉腹部段的分支之一，与肠系膜上动脉、肠系膜下动脉协同，通过一系列吻合支为腹部脏器提供血液供应。腹腔干缺失或其终末分支数量变异，可导致腹部动脉起源形式多样化，这可能对外科手术入路选择产生影响。
目的：分析腹腔干的解剖变异及其相关的外科临床潜在意义。
方法：本研究为系统综述，检索了2017年8月至9月期间PubMed、Lilacs、SciELO、Springerlink、Science Direct及Latindex数据库收录的相关文献。纳入标准为涉及人类腹腔干解剖变异的原创性研究。本研究的评估指标包括：腹腔干的存在与否、终末分支数量，以及偏离正常解剖模式的变异病例中其分支的起源位置。
结果：研究最终纳入12篇文献，均根据其样本量、解剖结构评估方法及主要研究结果进行了特征梳理。在多数研究中，正常解剖模式最为常见（占比75.0%）。检出病例中腹腔干缺失的比例为41.7%。最常见的解剖变异为腹腔干呈分叉型（占比66.7%）。此外还观察到：肝总动脉与脾动脉起源于肠系膜动脉的病例占比为25.0%；仅存在单一支脉的病例占16.7%，四分叉型变异（占比8.33%）为其余检出的变异类型。
结论：腹腔干变异并非罕见的解剖发现，目前已有多种不同的解剖变异类型被报道。因此，熟悉该结构的各类潜在变异具有重要临床价值，可为腹部区域相关的外科手术及影像学检查提供参考依据。