Proposal for a reclassification of liver based anatomy on portal ramifications

Am J Surg. 2005 Feb;189(2):195-9. doi: 10.1016/j.amjsurg.2004.04.014.

Abstract

Background: Portal branching patterns that differ from those previously described are occasionally encountered during liver surgery.

Methods: A total of 60 patients with normal intrahepatic venous anatomy underwent helical computed tomography during arterial portography (CTAP). Next, 3 dimensional portograms were reconstructed to verify the locations of the portal veins. Portal branching patterns in the right hemiliver were assessed.

Results: In all 60 patients examined, the right anterior portal vein bifurcated into the ventral and dorsal branches. In 42 (70%) of 60 patients, some branches arose from the right posterior portal trunk. Between 1 and 3 branches (mean 2.3 branches per patient) coursed cranially, between 2 and 5 branches (mean 3.2 branches per patient) coursed caudally, and between 1 and 2 branches (mean 1.3 branches per patient) coursed laterally.

Conclusions: We propose that the right liver should be divided into 3 segments, which are designated as the right anterior, middle, and posterior segments.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Gastrointestinal Neoplasms / surgery
  • Humans
  • Imaging, Three-Dimensional*
  • Liver / blood supply*
  • Liver / surgery*
  • Male
  • Middle Aged
  • Portal Vein / anatomy & histology*
  • Tomography, X-Ray Computed