Journal of Hepato-Biliary-Pancreatic Surgery

, Volume 15, Issue 6, pp 640–647

Connective tissue configuration in the human liver hilar region with special reference to the liver capsule and vascular sheath

  • Shogo Hayashi
  • Gen Murakami
  • Aiji Ohtsuka
  • Masahiro Itoh
  • Takashi Nakano
  • Yoshitaka Fukuzawa
Original Article

DOI: 10.1007/s00534-008-1336-8

Cite this article as:
Hayashi, S., Murakami, G., Ohtsuka, A. et al. J Hepatobiliary Pancreat Surg (2008) 15: 640. doi:10.1007/s00534-008-1336-8

Abstract

Background/Purpose

We carried out this study to examine the validity of the accepted dogma that: (1) the human liver capsule does not extend along the fissures for the hepatic veins; (2) the hilar vasculobiliary sheath does not connect to the liver capsule; and (3) the hilar plate is a thickening of the vasculobiliary sheath.

Methods

Using cadaveric specimens, we identified composite fibers and other structures in the sheath and capsule histologically.

Results

The liver capsule, Glisson’s sheath, and the sheath for the hepatic vein tributaries were characterized by a high content of thin, wavy elastic fibers. However, the hilar vasculobiliary sheath of the thick vessels and ducts did not contain elastic fibers. Along the roof of the hilar region, vaginal ductuli were identified as a chain of cross-sectional bile ducts with a relatively thick wall, because of their tortuous course with abundant small pouches budding from the surface. The ductuli were separated from the liver capsule by abundant lymphatic vessels.

Conclusions

The sheath for hepatic veins and Glisson’s sheath appear to connect to, and be continuous with, the liver capsule. During surgery and dissection, it should be borne in mind that the hilar plate is likely to be artificially developed when, without intention, surgeon bundle collagenous fibers with vaginal ductuli forming a core.

Key words

Liver capsuleGlisson’s sheathHilar plateElastic fiberVaginal ductuli

Copyright information

© Springer Japan 2008

Authors and Affiliations

  • Shogo Hayashi
    • 1
  • Gen Murakami
    • 2
  • Aiji Ohtsuka
    • 3
  • Masahiro Itoh
    • 4
  • Takashi Nakano
    • 5
  • Yoshitaka Fukuzawa
    • 1
  1. 1.Aichi Medical University Education Center (AMEC)AichiJapan
  2. 2.Iwamizawa Kojin-kai HospitalHokkaidoJapan
  3. 3.Department of AnatomyOkayama University School of MedicineOkayamaJapan
  4. 4.Department of AnatomyTokyo Medical UniversityTokyoJapan
  5. 5.Department of AnatomyAichi Medical UniversityAichiJapan