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Study of the Intersegmental Veins Between S5 and S8 Based on 3D Reconstruction

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Anatomic resection (AR) is a surgical method for treating hepatocellular carcinoma, and identifying intersegmental planes between segments 5 (S5) and 8 (S8) remains challenging. This study aims to find reliable intersegmental veins (IVs) between them as anatomical landmarks using 3D reconstruction analysis.

Methods

We retrospectively evaluated 57 patients who underwent multidetector-row CT scans from September 2021 to January 2023. The portal vein watershed of S5 and S8 and hepatic veins were reconstructed using 3D reconstruction analysis software. We counted and analyzed the IVs running within the intersegmental plane between S5 and S8, examined their features, and analyzed the location of the junctions between IVs and middle hepatic veins (MHVs).

Results

Among the 57 patients, 43 patients (75.4%) had IVs between S5 and S8. Most patients (81.4%) had a single IV joining the MHV, while 13.9% had two IVs, one joining the MHV and the other joining the right hepatic vein (RHV). The majority of IV-MHV junctions were found in the lower part of the MHVs. The most clearly identifiable junctions between the IVs and MHVs occurred slightly below the midpoint of the horizontal planes of the second hepatic portal and the center of the gallbladder bed.

Conclusion

Our study identified IVs between S5 and S8 in the liver as potential anatomical landmarks during AR for hepatocellular carcinoma surgery. We found three types of IVs and provided insights on how to locate their junctions with MHVs for easier surgical navigation. However, individual anatomical variations must be considered, and preoperative 3D reconstruction and personalized surgical planning are crucial for success. More research with larger sample sizes is needed to validate our findings and establish the clinical significance of these IVs as landmarks for AR.

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Data Availability

We are committed to data transparency and availability. The data supporting the findings of this study are available upon reasonable request. Researchers interested in accessing the data can contact Xiaodong Song. Due to privacy and ethical considerations, some restrictions may apply to the sharing of certain sensitive or confidential data. However, we will make every effort to provide the necessary data for replication and verification purposes in accordance with the journal's data sharing policies.

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Acknowledgements

We would like to express our sincere gratitude to the following individuals for their significant contributions to the scientific development and preparation of this manuscript: Xiaodong Song, for his invaluable guidance and expertise in the research methodology, as well as his critical review of the manuscript, which greatly improved its overall quality.

Hang Li, for sharing his profound knowledge in liver anatomy and providing constructive suggestions that enhanced the clarity and focus of the study.

Zili Shao, for his essential assistance in data analysis and interpretation, which played a crucial role in the robustness of our results.

Zebing Song, for his diligent efforts in managing the data collection process and ensuring the accuracy and completeness of the information obtained.

Mengling Han and Zongbing Cheng, for their technical support and assistance in 3D reconstruction and image analysis, which facilitated the visualization and understanding of the complex liver structures.

Their valuable insights, feedback, and support have been instrumental in the success of this study.

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Guangzhou Medical University, No. 250, Changgang Road, Guangzhou, 510260, China

    Hang Li, Zili Shao, Zebing Song, Mengling Han, Zongbing Cheng & Xiaodong Song

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  1. Hang Li
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  2. Zili Shao
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  3. Zebing Song
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Correspondence to Xiaodong Song.

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Li, H., Shao, Z., Song, Z. et al. Study of the Intersegmental Veins Between S5 and S8 Based on 3D Reconstruction. J Gastrointest Surg 27, 2085–2091 (2023). https://doi.org/10.1007/s11605-023-05766-x

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  • DOI: https://doi.org/10.1007/s11605-023-05766-x

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