Gastroduodenal artery

The gastroduodenal artery (GDA) is a major branch of the common hepatic artery, which itself arises from the celiac trunk. It is a short but clinically significant vessel that descends behind the first part of the duodenum, passing between the duodenal bulb and the head of the pancreas.

Origin and Course

The GDA typically originates from the common hepatic artery at the upper border of the first part of the duodenum. It courses inferiorly, passing posterior to the pylorus and the first portion of the duodenum, running along the anterior surface of the head of the pancreas.

Major Branches

The GDA divides into three principal terminal branches:

• Posterior superior pancreaticoduodenal artery

• Right gastroomental artery (Right gastro-omental) artery which runs along the greater curvature of the stomach within the greater omentum, supplying the stomach and the greater omentum.

• Anterior superior pancreaticoduodenal artery

• Additionally, small supraduodenal branches and retroduodenal branches may arise from the GDA to supply the anterosuperior aspect of the duodenum.

Clinical Significance

• Peptic ulcer disease: The GDA is the most common source of massive upper gastrointestinal hemorrhage from posterior duodenal ulcers, as erosion through the posterior wall of the duodenal bulb can directly erode into the artery.

• Pancreaticoduodenectomy (Whipple procedure): The GDA is a key landmark and is routinely ligated during this operation.

• Hepatic artery variations: Anatomic variants of the hepatic arterial system are common, and the relationship of the GDA to the proper hepatic artery and its branches is critical during hepatobiliary and pancreatic surgery.

• Interventional radiology: The GDA is frequently embolized in the setting of acute upper GI bleeding or as part of pre-procedural planning for hepatic radioembolization (Y-90) to prevent non-target embolization to the duodenum.

Collateral Circulation

The GDA plays an important role in collateral circulation between the celiac trunk and the superior mesenteric artery via the pancreaticoduodenal arcade. In cases of celiac artery stenosis or occlusion, retrograde flow through this arcade can maintain hepatic perfusion.