Liver

Abstract

The liver consists of a right and left lobe, which are divided by the gallbladder fossa and the falciform ligament. For clinical practice, the division of the liver into segments is important. In this context, the classification according to Couinaud and Bismuth is most commonly used (Fig. 24.1). In this classification, segments are separated by the right, middle, and left hepatic veins in one plane and by the portal vein in a perpendicular plane. The caudate lobe is defined as S1. Table 24.1 presents typical values regarding the anatomy and physiology of the liver.

The liver is supplied by both the hepatic artery (15–20%) and the portal vein (75–80%). The portal vein originates posterior to the pancreatic head/body where the superior mesenteric vein and the splenic vein unite and enter the porta hepatis along the hepatoduodenal ligament. The hepatic artery is a branch of the celiac trunk and also enters the liver via the hepatoduodenal ligament. The central veins of the hepatic lobules consecutively unite and finally form the right, middle, and left hepatic veins. These veins enter the inferior vena cava below the diaphragm.