Intrahepatic Venous Anastomoses with a Focus on the Middle Hepatic Vein Anastomoses in Normal Human Livers: Anatomical Study on Liver Corrosion Casts

Overview

Journal Surg Radiol Anat

Specialties Anatomy & Histology
General Surgery
Radiology

Date 2013 Sep 4

PMID 23999573

Citations 7

Authors

Marija Hribernik

Blaz Trotovsek

Affiliations

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Abstract

Purpose: The aim of this study is to present the anatomical data about intrahepatic venous anastomoses found in normal human livers. The focus is on the middle hepatic vein (MHV) anastomoses, because their existence or non-existence could be of crucial importance in tumour resections as well as in split or living donor liver transplantations.

Materials And Methods: The frequency of livers with intrahepatic venous anastomoses was determined on 164 corrosion casts and the diameter of each anastomosis was measured. Additionally, the type of connection and the position within the liver (liver segment) was determined for each MHV anastomosis.

Results: Intrahepatic venous anastomoses were found in 46 % (75/164), whereas MHV anastomoses were found in 28 % (44/164) of liver casts. Most commonly (39/44), MHV had anastomotic connections with the right hepatic vein (RHV), and also with the inferior RHV, the left hepatic vein and the short subhepatic vein. In more than three quarters of liver casts, MHV-RHV anastomoses were found in liver segment 8; in 45 % of cases, there was more than one anastomosis in this liver segment. The diameter of MHV-RHV anastomoses found in segment 8 was ≥1 mm in 90.6 % of cases.

Conclusion: As MHV anastomoses were present in more than a quarter of all examined liver casts, we believe that detailed anatomical data presented in this article, together with up to date radiologic technics which enable even 3D reconstruction of venous anastomoses in the liver, could contribute to the clinician's decisions when planning surgical procedures.

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References

Sommacale D, Farges O, Ettorre G, Lebigot P, Sauvanet A, Marty J . In situ split liver transplantation for two adult recipients. Transplantation. 2001; 69(5):1005-7. DOI: 10.1097/00007890-200003150-00060. View

Sano K, Makuuchi M, Miki K, Maema A, Sugawara Y, Imamura H . Evaluation of hepatic venous congestion: proposed indication criteria for hepatic vein reconstruction. Ann Surg. 2002; 236(2):241-7. PMC: 1422571. DOI: 10.1097/00000658-200208000-00013. View

Genc B, Solak A, Sahin N, Gur S, Kalaycioglu S, Ozturk V . Assessment of the coronary venous system by using cardiac CT. Diagn Interv Radiol. 2013; 19(4):286-93. DOI: 10.5152/dir.2013.012. View

Naganuma H, Ishida H, Konno K, Komatsuda T, Hamashima Y, Ishida J . Intrahepatic venous collaterals. Abdom Imaging. 1998; 23(2):166-71. DOI: 10.1007/s002619900313. View

Gadzijev E, Ravnik D, Stanisavljevic D, Trotovsek B . Venous drainage of the dorsal sector of the liver: differences between segments I and IX. A study on corrosion casts of the human liver. Surg Radiol Anat. 1997; 19(2):79-83. DOI: 10.1007/s00276-997-0079-6. View

Sakaguchi T, Suzuki S, Inaba K, Fukumoto K, Takehara Y, Nasu H . Analysis of intrahepatic venovenous shunt by hepatic venography. Surgery. 2010; 147(6):805-10. DOI: 10.1016/j.surg.2009.11.009. View

Cescon M, Sugawara Y, Sano K, Ohkubo T, Kaneko J, Makuuchi M . Right liver graft without middle hepatic vein reconstruction from a living donor. Transplantation. 2002; 73(7):1164-6. DOI: 10.1097/00007890-200204150-00028. View

Ou Q, Hermann R . The role of hepatic veins in liver operations. Surgery. 1984; 95(4):381-91. View

De Cecchis L, Hribernik M, Ravnik D, Gadzijev E . Anatomical variations in the pattern of the right hepatic veins: possibilities for type classification. J Anat. 2000; 197 Pt 3:487-93. PMC: 1468147. DOI: 10.1046/j.1469-7580.2000.19730487.x. View

10.

Yan L, Wu H, Chen Z, Luo Y, Lu Q, Zhang Z . Intrahepatic venous collaterals formation following outflow block in adult-to-adult living donor liver transplantation. J Surg Res. 2007; 146(2):172-6. DOI: 10.1016/j.jss.2007.05.017. View

11.

Fischer L, Schoebinger M, Neumann J, Muller S, Meinzer H, Buchler M . Does preoperative analysis of intrahepatic venous anastomoses improve the surgeon's intraoperative decision making? Pilot data from a case report. Patient Saf Surg. 2008; 2:19. PMC: 2542344. DOI: 10.1186/1754-9493-2-19. View

12.

LASINSKI W, Zientarski B . [The anastomotic system of sub-hepatic veins in man]. Bull Assoc Anat (Nancy). 1976; 60(170):559-66. View

13.

Hribernik M, Gadzijev E, Mlakar B, Ravnik D . Variations of intrahepatic and proximal extrahepatic bile ducts. Hepatogastroenterology. 2003; 50(50):342-8. View

14.

Satou S, Sugawara Y, Kokudo N, Makuuchi M . Preoperative detection of hepatic venous collaterals in right liver graft. Liver Transpl. 2005; 11(6):708-9. DOI: 10.1002/lt.20412. View

15.

COUINAUD C, Nogueira C . [The hepatic veins in humans]. Acta Anat (Basel). 1958; 34(1-2):84-110. View

16.

Kaneko T, Sugimoto H, Hirota M, Kure S, Kiuchi T, Nakao A . Intrahepatic venous anastomosis formation of the right liver in living donor liver transplantation: evaluations by Doppler ultrasonography and pulse-inversion ultrasonography with Levovist. Surgery. 2005; 138(1):21-7. DOI: 10.1016/j.surg.2005.03.012. View

17.

GOLDSMITH N, WOODBURNE R . The surgical anatomy pertaining to liver resection. Surg Gynecol Obstet. 1957; 105(3):310-8. View

18.

Buhe S, Miyaki T, Saito T, Sawuti A, Terayama H, Naito M . A study of the accessory hepatic vein to segments VI and VII with a morphological reconsideration of the human liver. Surg Radiol Anat. 2008; 30(3):201-7. DOI: 10.1007/s00276-008-0315-8. View