Skip to main content

Advertisement

SpringerLink
Log in

Liver morphology: anatomical study about the outer aspects

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

Abstract

Purpose

Hepatobilliary surgery is nowadays increasingly done throughout the world with advent of newer liver imaging modalities. Considering recent interest for accurate interpretation of different radiological images and performing surgical procedures, a precise understanding of hepatic surface anatomy is challenging due to high prevalence of previously identified morphological variations. Accordingly, a cadaveric study was attempted to revisit the morphological details of liver updating the unusual configurations along with their clinico-anatomical correlations and thus, compare the analysis of present study with previous published data.

Methods

We studied 110 formalin-fixed adult cadaveric livers of unknown age and sex having no pathological lesion or damage.

Results

More than one morphological variation in combination was observed on repeated occasions in same liver specimen. The anatomical classification based on Netter’s criteria was chosen in order to be coherent with previous studies to define different variations with addition of other subtypes. Accordingly, classical wedgeshaped livers were present in 57.3% specimens. Considering different morphological features, 78 (70.9%) variant livers were noted in terms of shape (as transverse saddle shaped, square shaped, globular, quadrilateral, pyriform or boot-shaped), altered numbers and position of fissures (affecting either one or more lobe in addition to absent fissure for ligamentum teres) or lobes (as aplasia, hypoplasia or hypertrophy) or processes (in addition to abnormalities of processes extending from caudate or quadrate lobe tongue-like process or appendix fibrosa hepatis or mini-accessory lobe) or impressions (as costal or variant visceral impressions affecting inferior surface) or evidence of pons hepatis(35.5%) orin combinations of all above.

Conclusion

Awareness of hepatic surface variation is worth knowing in successful planning of hepatobilliary surgeries with least complications.

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. Aktan ZA, Savas R, Pinar Y, Arslan O (2001) Lobe and segment anomalies of the liver. J Anat Soc India 50:15–16

    Google Scholar 

  2. Anjamrooz SH, Azari H (2012) Coexistence of multiple anomalies in the hepatobiliary system. Anat Cell Biol 45(1):62–65

    Article  PubMed Central  Google Scholar 

  3. Chaudhari HJ, Ravat MK, Vaniya VH, Vedi AN (2017) Morphological study of human liver and its surgical importance. J Clin Diagn Res 11(6):AC9–AC12

    Google Scholar 

  4. Chin J, Toole P, Lin J, Velavan SS (2018) Hepatic morphology: variations and its clinical importance. Eur J Anat 22(3):195–201

    Google Scholar 

  5. Dave MR, Rajguru J (2017) A study on the morphological variations of the human liver and its clinical implications. Natl J Integr Res Med 8(5):75–78

    Google Scholar 

  6. Glenisson M, Salloum C, Lim C, Lacaze L, Malek A, Enriquez A, Compagnon P, Laurent A, Azoulay D (2014) Accessory liver lobes: anatomical description and clinical implications. J Visc Surg 151(6):451–455

    Article  CAS  Google Scholar 

  7. Joshi SD, Joshi SS, Athavale SA (2009) Some interesting observations on the surface features of the liver and their clinical implications. Singapore Med J 50(7):715–719

    CAS  Google Scholar 

  8. Kogure K, Kojima I, Kuwano H, Matsuzaki T, Yorifuji H, Takata K, Makuuchi M (2014) Reconfirmation of the anatomy of the left triangular ligament and the appendix fibrosahepatis in human livers, and its implication in abdominal surgery. J Hepatobiliary Pancreat Sci 21(12):856–863

    Article  Google Scholar 

  9. Lazarus L, Luckrajh JS, Kinoo SM, Singh B (2018) Anatomical parameters of the Rouviere’s sulcus for laparoscopic cholecystectomy. Eur J Anat 22(5):389–395

    Google Scholar 

  10. Macchi V, Feltrin G, Parenti A, De Caro R (2003) Diaphragmatic sulci and portal fissures. J Anat 202(Pt 3):303–308

    Article  PubMed Central  Google Scholar 

  11. Mokdad AA, Lopez AD, Shahraz S, Lozano R, Mokdad AH, Stanaway J et al (2014) Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis. BMC Med 12:145

    Article  PubMed Central  Google Scholar 

  12. Nagato AC, Silva MAS, Trajano ETL, Alves JN, Bandeira ACB, Ferreira TA, Valenca SS, Bezerra FS (2011) Quantitative and morphological analyses of different types of human liver. J Morphol Sci 28(4):275–279

    Google Scholar 

  13. Nayak BS (2013) A study on the anomalies of liver in the South Indian cadavers. Int J Morphol 31(2):658–661

    Article  Google Scholar 

  14. Nayak SB, Surendran S, Nelluri VM, Kumar N, Aithal AP (2016) A south Indian cadaveric study about the relationship of hepatic segment of inferior vena cava with the liver. J ClinDiagn Res 10(8):AC04–AC07

    Google Scholar 

  15. Netter FH (2000) Atlas of human anatomy, 2nd edn. Guilford Press, New York

    Google Scholar 

  16. Othman FB, Latiff AA, Suhaimi FH, Das S (2008) Accessory sulci of the liver. An anatomical study with clinical implications. Saudi Med J 29:1247–1249

    Google Scholar 

  17. Patil S, Sethi M, Kakar S (2014) Morphological study of human liver and its surgical importance. Int J Anat Res 2(2):310–314

    Google Scholar 

  18. Phad VV, Syed SA, Joshi RA (2014) Morphological variations of liver. Int J Health Sci Res 4:119–124

    Google Scholar 

  19. Reddy N, Joshi SS, Mittal PS, Joshi SD (2017) Morphology of caudate and quadrate lobes of liver. J Evolution Med Dent Sci 6(11):897–901

    Article  Google Scholar 

  20. Saritha S, Ramani N, Yesender A (2015) Cadaveric study of morphological variations in the human liver and its clinical importance. Int J Med Sci Clin Invent 2(6):1020–1031

    Google Scholar 

  21. Sato S, Wantanabe M, Nagasawa S (1998) Laparoscopic observations of congenital anomalies of the liver. Gastrointest Endosc 47(2):136–140

    Article  CAS  Google Scholar 

  22. Saxena A, Agarwal KK, Jakhwal C, Singh S, Das AR (2016) Some variable facts of liver: embryological and clinical perspective. Int J Anat Radiol Surg 5(1):64–67

    Google Scholar 

  23. Singh HR, Rabi S (2019) Study of morphological variations of liver in human. Transl Res Anatomy 14:1–5

    Article  Google Scholar 

  24. Tsegaye M, Assegedech B, Assefa G (2017) Assessment of morphological variations and its specific location on the surface of adult human liver in Ethiopian cadavers. Int J Med Res Health Sci 6(10):121–129

    Google Scholar 

  25. Vilgrain V, Lagadec M, Ronot M (2016) Pitfalls in liver imaging. Radiology 278(1):34–51

    Article  Google Scholar 

  26. Vinnakota S, Jayasree N (2013) A new insight into the morphology of human liver: a cadaveric study. Int Sch Res Notices 689564:1–6

    Google Scholar 

Download references

Acknowledgements

Authors acknowledge the great help received from the Department of Anatomy of this institute.

Funding

Not applicable.

Author information

Authors and Affiliations

  1. Department of Anatomy, Calcutta National Medical College, 32, Gorachand Road, Kolkata, 700014, West Bengal, India

    Phalguni Srimani & Anubha Saha

  2. Sananda, 17/1A Canal South Road, Purbachal, Kasba, Kolkata, 700078, West Bengal, India

    Anubha Saha

Authors
  1. Phalguni Srimani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anubha Saha
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SP Project development, data collection, manuscript writing. SA Data management, analysis, manuscript editing.

Corresponding author

Correspondence to Anubha Saha.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Srimani, P., Saha, A. Liver morphology: anatomical study about the outer aspects. Surg Radiol Anat 42, 1425–1434 (2020). https://doi.org/10.1007/s00276-020-02485-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-020-02485-9

Keywords

Search

Navigation