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Liver Anatomy: Variant Venous Anatomy and Implications for Resection

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Venous Embolization of the Liver

Abstract

The complexity of radiologic and surgical interventions on the liver has increased in the last decade. Knowledge of anatomical variants is crucial for safe hepatic resection and for preservation of adequate inflow and outflow to the functional remnant liver tissue. There are many congenital and acquired anomalies of the portal vein that need to be identified preoperatively, and their presence may indicate concomitant variations in biliary ductal anatomy.

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References

  1. Joyce AD, Howard ER. Rare congenital anomaly of the portal vein. Br J Surg. 1988;75(10):1038-1039.

    Article  PubMed  CAS  Google Scholar 

  2. Marks C. Developmental basis of the portal venous system. Am J Surg. 1969;117(5):671-681.

    Article  PubMed  CAS  Google Scholar 

  3. Massin M, Verloes A, Jamblin P. Cardiac anomalies associated with congenital absence of the portal vein. Cardiol Young. 1999;9(5):522-525.

    Article  PubMed  CAS  Google Scholar 

  4. Walsh G, Williams MP. Congenital anomalies of the portal venous system – CT appearances with embryological considerations. Clin Radiol. 1995;50(3):174-176.

    Article  PubMed  CAS  Google Scholar 

  5. Gallego C, Velasco M, Marcuello P, Tejedor D, De Campo L, Friera A. Congenital and acquired anomalies of the portal venous system. Radiographics. 2002;22(1):141-159.

    PubMed  Google Scholar 

  6. Hu GH, Shen LG, Yang J, Mei JH, Zhu YF. Insight into congenital absence of the portal vein: Is it rare? World J Gastroenterol. 2008;14(39):5969-5979.

    Article  PubMed  Google Scholar 

  7. Laverdiere JT, Laor T, Benacerraf B. Congenital absence of the portal vein: case report and MR demonstration. Pediatr Radiol. 1995;25(1):52-53.

    Article  PubMed  CAS  Google Scholar 

  8. Zhang JS, Wang YP, Wang MQ, et al. Diagnosis of an accessory portal vein and its clinical implications for portosystemic shunts. Cardiovasc Interv Radiol. 1996;19(4):239-241.

    Article  CAS  Google Scholar 

  9. Parisato FO, Pataro EF. Anomalous portal vein. Vena porta anomalia. Angiologia. 1965;17(3):119-123.

    PubMed  CAS  Google Scholar 

  10. Lundstedt C, Lindell G, Tranberg KG, Svartholm E. Congenital absence of the intrahepatic portion of the portal vein in an adult male resected for hepatocellular carcinoma. Eur Radiol. 2001;11(11):2228-2231.

    Article  PubMed  CAS  Google Scholar 

  11. Guariso G, Fiorio S, Altavilla G, et al. Congenital absence of the portal vein associated with focal nodular hyperplasia of the liver and cystic dysplasia of the kidney. Eur J Pediatr. 1998;157(4):287-290.

    Article  PubMed  CAS  Google Scholar 

  12. Marois D, van Heerden JA, Carpenter HA, Sheedy PF 2nd. Congenital absence of the portal vein. Mayo Clin Proc. 1979;54(1):55-59.

    PubMed  CAS  Google Scholar 

  13. Matsuoka Y, Ohtomo K, Okubo T, Nishikawa J, Mine T, Ohno S. Congenital absence of the portal vein. Gastrointest Radiol. 1992;17(1):31-33.

    Article  PubMed  CAS  Google Scholar 

  14. Nakasaki H, Tanaka Y, Ohta M, et al. Congenital absence of the portal vein. Ann Surg. 1989;210(2):190-193.

    Article  PubMed  CAS  Google Scholar 

  15. Covey AM, Brody LA, Getrajdman GI, Sofocleous CT, Brown KT. Incidence, patterns, and clinical relevance of variant portal vein anatomy. AJR Am J Roentgenol. 2004;183(4):1055-1064.

    PubMed  Google Scholar 

  16. Cheng YF, Huang TL, Chen CL, et al. Anatomic dissociation between the intrahepatic bile duct and portal vein: risk factors for left hepatectomy. World J Surg. 1997;21(3):297-300.

    Article  PubMed  CAS  Google Scholar 

  17. Ko S, Murakami G, Kanamura T, Sato TJ, Nakajima Y. Cantlie’s plane in major variations of the primary portal vein ramification at the porta hepatitis: cutting experiment using cadaveric livers. World J Surg. 2004;28(1):13-18.

    Article  PubMed  Google Scholar 

  18. Yamane T, Mori K, Sakamoto K, Ikei S, Akagi M. Intrahepatic ramification of the portal vein in the right and caudate lobes of the liver. Acta Anat. 1988;133(2):162-172.

    Article  PubMed  CAS  Google Scholar 

  19. Kitami M, Takase K, Murakami G, et al. Types and frequencies of biliary tract variations associated with a major portal venous anomaly: analysis with multi-detector row CT cholangiography. Radiology. 2006;238(1):156-166.

    Article  PubMed  Google Scholar 

  20. Goldsmith NA, Woodburne RT. The surgical anatomy pertaining to liver resection. Surg Gynecol Obstet. 1957;105:310-318.

    PubMed  CAS  Google Scholar 

  21. Hata F, Hirata K, Murakami G, Mukaiya M. Identification of segments VI and VII of the liver based on the ramification patterns of the intrahepatic portal and hepatic veins. Clin Anat. 1999;12(4):229-244.

    Article  PubMed  CAS  Google Scholar 

  22. Atri M, Bret PM, Fraser-Hill MA. Intrahepatic portal venous variations: prevalence with ultrasound. Radiology. 1992;184:523-526.

    Google Scholar 

  23. Cheng YF, Huang TL, Chen CL, Chen YS, Lee TY. Variations of the intrahepatic bile ducts: application in living related liver transplantation and splitting liver transplantation. Clin Transplant. 1997;11(4):337-340.

    PubMed  CAS  Google Scholar 

  24. Filly RA, Laing FC. Anatomic variation of portal venous anatomy in the porta hepatitis: ultrasonographic evaluation. J Clin Ultrasound. 1978;6(2):83-89.

    Article  PubMed  CAS  Google Scholar 

  25. Williams PL. Veins of the abdomen and pelvis: hepatic portal system. In: Williams PL, ed. Gray’s Anatomy. 38th ed. New York: Churchill Livingstone; 1999:1602-1604.

    Google Scholar 

  26. Cho KC, Patel YD, Wachsberg RH, Seeff J. Varices in portal hypertension: evaluation with CT. Radiographics. 1995;15(3):609-622. A review publication of the Radiological Society of North America, Inc.

    PubMed  CAS  Google Scholar 

  27. Ito K, Higuchi M, Kada T, et al. CT of acquired abnormalities of the portal venous system. Radiographics. 1997;17(4):897-917.

    PubMed  CAS  Google Scholar 

  28. De Gaetano AM, Lafortune M, Patriquin H, De Franco A, Aubin B, Paradis K. Cavernous transformation of the portal vein: patterns of intrahepatic and splanchnic collateral circulation detected with Doppler sonography. Am J Roentgenol. 1995;165(5):1151-1155.

    Google Scholar 

  29. Ishiyama S, Yamada Y, Narishima Y, Yamaki T, Kunii Y, Yamauchi H. Surgical anatomy of the hilar bile duct. Tan Sui J Biliary Tract Pancreas. 1999;20:811-820.

    Google Scholar 

  30. Kumon M, Matsuhima M, Itahara T. Gross anatomy of the liver hilus and caudate lobe using corrosion casts of the liver. Tan Sui Biliary Tract Pancreas. 1989;10:1417-1422.

    Google Scholar 

  31. Abulkhir A, Limongelli P, Healey AJ, et al. Preoperative portal vein embolization for major liver resection: a meta-analysis. Ann Surg. 2008;247(1):49-57.

    Article  PubMed  Google Scholar 

  32. Covey AM, Brown KT, Jarnagin WR, et al. Combined portal vein embolization and neoadjuvant chemotherapy as a treatment strategy for resectable hepatic colorectal metastases. Ann Surg. 2008;247(3):451-455.

    Article  PubMed  Google Scholar 

  33. Kinoshita H, Sakai K, Hirohashi K. Preoperative portal vein embolization for hepatocellular carcinoma. World J Surg. 1986;10(5):803-808.

    Article  PubMed  CAS  Google Scholar 

  34. Makuuchi M, Thai BL, Takayasu K, et al. Preoperative portal embolization to increase safety of major hepatectomy for hilar bile duct carcinoma: a preliminary report. Surgery. 1990;107(5):521-527.

    PubMed  CAS  Google Scholar 

  35. Bax HR, Mansens BJ, Schalm L. Atrophy of the liver after occlusion of the bile ducts or portal vein and compensatory hypertrophy of the unoccluded portion and its clinical importance. Gastroenterology. 1956;31(2):131-155.

    PubMed  CAS  Google Scholar 

  36. Makuuchi M et al. Preoperative transcatheter embolization of the portal venous branch for patients receiving extended lobectomy due to the bile duct carcinoma. J Jpn Soc Clin Surg. 1984;45:1558.

    Google Scholar 

  37. Nakamura S, Tsuzuki T. Surgical anatomy of the hepatic veins and the inferior vena cava. Surg Gynecol Obstet. 1981;152(1):43-50.

    PubMed  CAS  Google Scholar 

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Correspondence to Anne M. Covey .

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Maker, A.V., Jarnagin, W.R., Covey, A.M. (2011). Liver Anatomy: Variant Venous Anatomy and Implications for Resection. In: Madoff, D., Makuuchi, M., Nagino, M., Vauthey, JN. (eds) Venous Embolization of the Liver. Springer, London. https://doi.org/10.1007/978-1-84882-122-4_5

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  • DOI: https://doi.org/10.1007/978-1-84882-122-4_5

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