Skip to main content
SpringerLink
Log in

Termination of the ligamentum venosum and the topographic relationship between the left portal vein, left hepatic artery, and ligamentum venosum in the fissures for the ligamentum teres and ligamentum venosum

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to clarify the location of termination of the ligamentum venosum (LV) and topographic relationships between the left portal vein (LPV), left hepatic artery (LHA), and LV in the fissures for ligamentum teres and LV.

Methods

Anatomical examination was performed on 50 livers from embalmed Korean adult cadavers.

Results

The LV originated from a point between the transverse and umbilical portions of LPV (Tr-Um point) in all specimens, and terminated in the common trunk of the middle hepatic vein and left hepatic vein (LHV) (61 %) or in the LHV (39 %). In the fissures for ligamentum teres and LV, the courses of the LHA relative to the LV and the LPV varied, such that four main patterns could be discerned. In type I (48 %), the LHA crossed the inferior surface of Tr-Um point and passed just left of the origin of LV. In type II (20 %), the LHA crossed the inferior surface of umbilical portion of LPV. In type III (10 %), the LHA crossed the inferior surface of Tr-Um point to pass just left of origin of LV, with one branch of the right hepatic artery crossing the inferior surface of umbilical portion of LPV. In type IV (12 %), no arterial branches ran on the inferior surfaces of transverse and umbilical portions of LPV.

Conclusion

These details may play a role as external landmarks for facilitating preestimation of intrahepatic structures during various surgical procedures involving the liver.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Dahmane R, Morjane A, Ravnik D, Hribernik M (2009) Anatomy of the ligamentum venosum Arantii and its contribution to the left hepatic vein and common trunk control. Cells Tissues Organs 190:297–300

    Article  PubMed  Google Scholar 

  2. Endo I, Shimada H, Sugita M, Fujii Y, Morioka D, Takeda K, Sugae S, Tanaka K, Togo S, Bourquain H, Peitgen HO (2007) Role of three-dimensional imaging in operative planning for hilar cholangiocarcinoma. Surgery 142:666–675

    Article  PubMed  Google Scholar 

  3. Hara Y, Sato Y, Yamamoto S, Oya H, Igarashi M, Abe S, Kokai H, Miura K, Suda T, Nomoto M, Aoyagi Y, Hatakeyama K (2013) Successful laparoscopic division of a patent ductus venosus: report of a case. Surg Today 43:434–438

    Article  PubMed  Google Scholar 

  4. Hollinshead WH (1971) Anatomy for surgeons: volume 2, the thorax, abdomen, and pelvis, 2nd edn. Harper & Row, New York, p 317

    Google Scholar 

  5. Ibukuro K, Takeguchi T, Fukuda H, Abe S, Tobe K, Tagawa K (2013) Spatial relationship between the hepatic artery and portal vein based on the fusion image of CT angiography and CT arterial portography: the left hemiliver. AJR Am J Roentgenol 200:1160–1166

    Article  PubMed  Google Scholar 

  6. Ikeda S, Yamaguchi Y, Sera Y, Ohshiro H, Uchino S, Ogawa M (1999) Surgical correction of patent ductus venosus in three brothers. Dig Dis Sci 44:582–589

    Article  CAS  PubMed  Google Scholar 

  7. Kamimatsuse A, Onitake Y, Kamei N, Tajima G, Sakura N, Sueda T, Hiyama E (2010) Surgical intervention for patent ductus venosus. Pediatr Surg Int 26:1025–1030

    Article  PubMed  Google Scholar 

  8. Llanos D, Armijo J, Bodas A, Vaquero E, de la Pedraja I, Arrazola J (2014) Transjugular closure of patent ductus venosus in a symptomatic 14-year-old boy using a vascular plug. J Pediatr 164:426.e1-2

    Article  PubMed  Google Scholar 

  9. Majno PE, Mentha G, Morel P, Segalin A, Azoulay D, Oberholzer J, Le Coultre C, Fasel J (2002) Arantius’ ligament approach to the left hepatic vein and to the common trunk. J Am Coll Surg 195:737–739

    Article  PubMed  Google Scholar 

  10. Morris H (1947) Morris’ human anatomy: a complete systemic treatise, 10th edn. Blakiston Co, Philadelphia, p 1348

    Google Scholar 

  11. Meyer WW, Lind J (1966) The ductus venosus and the mechanism of its closure. Arch Dis Child 41:597–605

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Murayama K, Nagasaka H, Tate K, Ohsone Y, Kanazawa M, Kobayashi K, Kohno Y, Takayanagi M (2006) Significant correlations between the flow volume of patent ductus venosus and early neonatal liver function: possible involvement of patent ductus venosus in postnatal liver function. Arch Dis Child Fetal Neonatal Ed 91:F175–F179

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Nagino M, Nimura Y, Nishio H, Ebata T, Igami T, Matsushita M, Nishikimi N, Kamei Y (2010) Hepatectomy with simultaneous resection of the portal vein and hepatic artery for advanced perihilar cholangiocarcinoma: an audit of 50 consecutive cases. Ann Surg 252:115–123

    Article  PubMed  Google Scholar 

  14. Saito M, Seo Y, Yano Y, Momose K, Hirano H, Yoshida M, Azuma T (2013) Successful treatment using coil embolization of a symptomatic intrahepatic portosystemic venous shunt developing through a patent ductus venosus in a noncirrhotic adult. Intern Med 52:555–559

    Article  PubMed  Google Scholar 

  15. Sareli M, Chanukvadze I, Valeanu A, Zippel DB, Shapiro R, Papa MZ (2009) The posterior intrahepatic approach to the left portal pedicle using the ligamentum venosum: anatomical basis. Surg Radiol Anat 31:809–813

    Article  PubMed  Google Scholar 

  16. Sharma R, Crowley J, Squires R, Bond G, Sindhi R, Mazariegos G, Soltys K (2013) Neonatal acute liver failure complicated by patent ductus venosus: diagnosis and management. Liver Transpl 19:1049–1052

    Article  PubMed  Google Scholar 

  17. Standring S (2008) Gray’s anatomy, 40th edn. Elsevier/Churchill Livingstone, New York, pp 1168–1171

    Google Scholar 

  18. Stewart WB (1923) The ductus venosus in the fetus and in the adult. Anat Rec 25:225–235

    Article  Google Scholar 

  19. Woodburne RT, Burkel WE (1994) Essentials of human anatomy, 9th edn. Oxford University Press, New York, p 467

    Google Scholar 

  20. Yoshimoto Y, Shimizu R, Saeki T, Harada T, Sugio Y, Nomura S, Tanaka H (2004) Patent ductus venosus in children: a case report and review of the literature. J Pediatr Surg 39:E1–E5

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Anatomy, Catholic Kwandong University College of Medicine, Room 502, Naegok-Dong 522, Gangneung, 210-701, South Korea

    Mi-Sun Hur, Ho-Jeong Kim & Kyu-Seok Lee

Authors
  1. Mi-Sun Hur
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ho-Jeong Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kyu-Seok Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kyu-Seok Lee.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hur, MS., Kim, HJ. & Lee, KS. Termination of the ligamentum venosum and the topographic relationship between the left portal vein, left hepatic artery, and ligamentum venosum in the fissures for the ligamentum teres and ligamentum venosum. Surg Radiol Anat 37, 449–455 (2015). https://doi.org/10.1007/s00276-014-1367-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-014-1367-6

Keywords

Search

Navigation