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Journal of Hepato-Biliary-Pancreatic Surgery

, Volume 11, Issue 6, pp 390–396 | Cite as

Anterior fissure of the right liver — the third door of the liver

  • Akihiro Cho
  • Shinichi Okazumi
  • Harufumi Makino
  • Fumihiko Miura
  • Kiyohiko Shuto
  • Ryouyu Mochiduki
  • Takayuki Tohma
  • Hidehiro Kudo
  • Katsuhiko Matsubara
  • Hisashi Gunji
  • Hiroshi Yamamoto
  • Munemasa Ryu
  • Takenori Ochiai
Basic knowledge of interest

Abstract

Background/Purpose

Although the anterior segment of the liver has been divided into segments 8 and 5, we have, during surgical or interventional procedures, occasionally encountered patients in whom the right anterior portal vein does not bifurcate into the superior and inferior branches. Thus, the in vivo anatomy of the right liver was reevaluated to clarify the segmental anatomy.

Methods

We evaluated the hepatic venous and portal ramification patterns, using three-dimensional images reconstructed from computed tomography. In addition, liver volumetry was performed.

Results

All branches arising from the anterior trunk were divided into two groups: the right ventral portal branches (RVP) and the right dorsal portal branches (RDP), and the anterior fissure vein crossed between the RVP and RDP. The ventral and dorsal regions of the anterior segment were approximately equal from a volumetric point of view.

Conclusions

The anterior segment seems to be divided into the ventral and dorsal segments by the anterior fissure, and we propose a reclassification of the right liver that divides the right liver into three segments. Dissection of the parenchyma along the anterior fissure makes the third door of the liver open, resulting in the exposing of all Glissonian pedicles of the right liver. The introduction of our segmental anatomy and surgical procedure will allow more systematic and limited liver resections.

Key words

Anterior segment Anterior fissure Anterior fissure vein 

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Copyright information

© Springer-Verlag Tokyo 2004

Authors and Affiliations

  • Akihiro Cho
    • 1
  • Shinichi Okazumi
    • 2
  • Harufumi Makino
    • 3
  • Fumihiko Miura
    • 4
  • Kiyohiko Shuto
    • 2
  • Ryouyu Mochiduki
    • 2
  • Takayuki Tohma
    • 2
  • Hidehiro Kudo
    • 2
  • Katsuhiko Matsubara
    • 2
  • Hisashi Gunji
    • 2
  • Hiroshi Yamamoto
    • 5
  • Munemasa Ryu
    • 6
  • Takenori Ochiai
    • 2
  1. 1.Department of SurgerySeirei Sakura HospitalChibaJapan
  2. 2.Department of Academic Surgery, Graduate School of MedicineChiba UniversityChibaJapan
  3. 3.Research Center for Frontier Medical EngineeringChiba UniversityChibaJapan
  4. 4.Department of SurgeryTeikyo University School of MedicineTokyoJapan
  5. 5.Department of SurgeryChiba Cancer Center HospitalChibaJapan
  6. 6.Department of SurgeryChiba Prefectural Sawara HospitalChibaJapan

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