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Relation between Hepatic and Portal Veins in the Right Paramedian Sector: Proposal for Anatomical Reclassification of the Liver

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Abstract

Although a right liver graft without a middle hepatic vein resulted in potential venous congestion in the right paramedian sector, the details of the hepatic venous distribution in the right paramedian sector have not been established. In this study, the ramification patterns of the hepatic veins draining the right anterosuperior segment (S8) and the relation between the hepatic and portal veins were assessed using multislice computed tomography in 44 patients without lesions in the liver. All 52 drainage veins of the ventral area of S8 joined the middle hepatic vein, and all 48 drainage veins of the dorsal area joined the right hepatic vein. The hepatic vein crossing between the ventral and dorsal areas was observed in each patient examined. Therefore, we propose a reclassification wherein the right paramedian sector is divided into ventral and dorsal segments. This new classification may contribute to the development of new and safer surgical procedures, including more limited resection and right lobe adult living donor liver transplantation to avoid graft congestion.

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References

  1. C Couinaud (1989) Surgical Anatomy of the Liver Revisited Couinaud Paris

    Google Scholar 

  2. H Bismuth (1982) ArticleTitleSurgical anatomy and anatomical surgery of the liver World J. Surg. 6 3–9 Occurrence Handle1:STN:280:Bi2B38rotF0%3D Occurrence Handle7090393

    CAS  PubMed  Google Scholar 

  3. A Cho S Okazumi W Takayama (2000) ArticleTitleAnatomy of the right anterosuperior area (segment 8) of the liver: evaluation with helical CT during arterial portography Radiology 214 491–495 Occurrence Handle10671598

    PubMed  Google Scholar 

  4. A Cho M Ryu T Okada (2002) ArticleTitleS5 resection based on a new classification of the liver (in Japanese) Operation 56 627–630

    Google Scholar 

  5. MS Leeuwen ParticleVan J Noordzij MA Fernandez (1994) ArticleTitlePortal venous and segmental anatomy of the right hemiliver: observation based on three-dimensional spiral CT renderings AJR. Am. J. Roentgenol. 163 1395–1404 Occurrence Handle7992736

    PubMed  Google Scholar 

  6. GD Rubin MD Dake SA Napel (1993) ArticleTitleThree-dimensiomal spiral CT angiography of the abdomen: initial clinical experience Radiology 186 147–152 Occurrence Handle1:STN:280:ByyC3c7nvVI%3D Occurrence Handle8416556

    CAS  PubMed  Google Scholar 

  7. H Furukawa K Sano T Kosuge (1997) ArticleTitleAnalysis of biliary drainage in the caudate lobe of the liver: comparison of three-dimensional CT cholangiography and rotating cine cholangiography Radiology 204 113–117 Occurrence Handle1:STN:280:ByiA2cbit1M%3D Occurrence Handle9205231

    CAS  PubMed  Google Scholar 

  8. Y Shinohara M Ryu (1995) ArticleTitleDemonstration of the hilar biliary confluence using 3D computed tomography Semin. Intervent. Radiol. 12 138–145

    Google Scholar 

  9. K Takayasu N Moriyama Y Muramatsu (1985) ArticleTitleIntrahepatic portal vein branches studied by percutaneous transhepatic portography Radiology 154 31–36 Occurrence Handle1:STN:280:BiqD28vlvVM%3D Occurrence Handle3964948

    CAS  PubMed  Google Scholar 

  10. M Makuuchi H Hasegawa S Yamazaki (1985) ArticleTitleUltrasonically guided subsegmentectomy Surg. Gynecol. Obstet. 161 346–350 Occurrence Handle1:STN:280:BimD3MbktVI%3D Occurrence Handle2996162

    CAS  PubMed  Google Scholar 

  11. P Soyer A Roche M Gad (1991) ArticleTitlePreoperative segmental localization of hepatic metastases: utility of three-dimensional CT during arterial portography Radiology 180 653–658 Occurrence Handle1:STN:280:By6A3svnsFI%3D Occurrence Handle1871274

    CAS  PubMed  Google Scholar 

  12. GA Waggenspack DR Tabb V Tiruchelvam (1993) ArticleTitleThree-dimensional localization of hepatic neoplasms with computer-generated scissurae recreated from axial CT and MR images AJR. Am. J. Roentgenol. 160 307–309 Occurrence Handle1:STN:280:ByyC2c3msFY%3D Occurrence Handle8424339

    CAS  PubMed  Google Scholar 

  13. RC Nelson JL Chezmar PH Sugarbaker (1990) ArticleTitlePreoperative localization of focal liver lesions to specific liver segments: utility of CT during arterial portography Radiology 176 89–94 Occurrence Handle1:STN:280:By%2BB1c%2Fnslw%3D Occurrence Handle2353115

    CAS  PubMed  Google Scholar 

  14. S Togo H Shimada E Kanemura (1998) ArticleTitleUsefulness of three-dimensional computed tomography for anatomical liver resection: sub-subsegmentectomy Surgery 123 73–78 Occurrence Handle10.1067/msy.1998.83280 Occurrence Handle1:STN:280:DyaK1c7hvVCgsg%3D%3D Occurrence Handle9457226

    Article  CAS  PubMed  Google Scholar 

  15. S Nakamura S Sakaguchi T Hachiya (1993) ArticleTitleSignificance of hepatic vein reconstruction in hepatectomy Surgery 114 59–64 Occurrence Handle1:STN:280:ByyA283gslM%3D Occurrence Handle8356528

    CAS  PubMed  Google Scholar 

  16. A Maema H Imamura T Takayama (2002) ArticleTitleImpaired volume regeneration of split livers with partial venous disruption: a latent problem in partial liver transplantation Transplantation 73 765–769

    Google Scholar 

  17. HP Grewal MH Shokouh-Amiri S Vera (2001) ArticleTitleSurgical technique for right lobe adult living donor liver transplantation without venovenous bypass or portocaval shunting and with duct-to-duct biliary reconstruction Ann. Surg. 233 502–508 Occurrence Handle10.1097/00000658-200104000-00004 Occurrence Handle1:STN:280:DC%2BD3M3kvVajsg%3D%3D Occurrence Handle11303131

    Article  CAS  PubMed  Google Scholar 

  18. RM Ghobrial CB Hsieh S Lerner (2001) ArticleTitleTechnical challenges of hepatic venous outflow reconstruction in right adult living donor liver transplantation Liver Transpl. 7 551–555 Occurrence Handle10.1053/jlts.2001.24910 Occurrence Handle1:STN:280:DC%2BD3MzoslGisw%3D%3D Occurrence Handle11443587

    Article  CAS  PubMed  Google Scholar 

  19. M Cescon Y Sugawara K Sano (2002) ArticleTitleRight liver graft without middle hepatic vein reconstruction from a living donor Transplantation 73 1164–1166

    Google Scholar 

  20. SG Lee KM Park S Hwang (2001) ArticleTitleCongestion of right liver graft in living donor liver transplantation Transplantation 71 812–817 Occurrence Handle1:STN:280:DC%2BD3MzntVCqtA%3D%3D Occurrence Handle11330547

    CAS  PubMed  Google Scholar 

  21. Y Sugawara M Makuuchi H Imamura (2002) ArticleTitleOutflow reconstruction in recipients of right liver graft from living donors Liver Transpl. 8 167–168 Occurrence Handle10.1053/jlts.2002.30580 Occurrence Handle11862595

    Article  PubMed  Google Scholar 

  22. MM Kinkhabwala JV Guarrera R Brown (2003) ArticleTitleOutflow reconstruction in right hepatic live donor liver transplantation Surgery 133 243–250 Occurrence Handle10.1067/msy.2003.18 Occurrence Handle12660634

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Academic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, 260-0856, Chuou-ku, Chiba, Japan

    Akihiro Cho M.D., Shinichi Okazumi M.D., Harufumi Makino M.D., Fumihiko Miura M.D., Gaku Ohira M.D., Yushin Yoshinaga M.D., Takayuki Toma M.D., Hidehiro Kudo M.D., Katsuhiko Matsubara M.D. & Takenori Ochiai M.D., Ph.D.

  2. Department of Surgery, Chiba Prefectural Sawara Hospital, 2285 Sawara, 287-0003, Chiba, Japan

    Munemasa Ryu M.D.

Authors
  1. Akihiro Cho M.D.
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  2. Shinichi Okazumi M.D.
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  3. Harufumi Makino M.D.
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  4. Fumihiko Miura M.D.
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  5. Gaku Ohira M.D.
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  6. Yushin Yoshinaga M.D.
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  7. Takayuki Toma M.D.
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  8. Hidehiro Kudo M.D.
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  9. Katsuhiko Matsubara M.D.
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  10. Munemasa Ryu M.D.
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  11. Takenori Ochiai M.D., Ph.D.
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Correspondence to Akihiro Cho M.D..

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Cho, A., Okazumi, S., Makino, H. et al. Relation between Hepatic and Portal Veins in the Right Paramedian Sector: Proposal for Anatomical Reclassification of the Liver. World J. Surg. 28, 8–12 (2004). https://doi.org/10.1007/s00268-003-7038-0

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  • DOI: https://doi.org/10.1007/s00268-003-7038-0

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