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Accessory sulci of the liver. An anatomical study with clinical implications

Othman FB, Latiff AA, Suhaimi FH, Das S

Saudi Med J, 2008 Sep;29(9):1247-9.
PMID: 18813405

To study the presence of accessory sulcus (AS) in the embalmed cadaveric livers, and compare it with the normal liver.

Matched MeSH terms: Hepatic Veins/anatomy & histology
Automatic atlas-based liver segmental anatomy identification for hepatic surgical planning

Alirr OI, Abd Rahni AA

Int J Comput Assist Radiol Surg, 2020 Feb;15(2):239-248.
PMID: 31617057 DOI: 10.1007/s11548-019-02078-x

PURPOSE: For the liver to remain viable, the resection during hepatectomy procedure should proceed along the major vessels; hence, the resection planes of the anatomic segments are defined, which mark the peripheries of the self-contained segments inside the liver. Liver anatomic segments identification represents an essential step in the preoperative planning for liver surgical resection treatment.
METHOD: The method based on constructing atlases for the portal and the hepatic veins bifurcations, the atlas is used to localize the corresponding vein in each segmented vasculature using atlas matching. Point-based registration is used to deform the mesh of atlas to the vein branch. Three-dimensional distance map of the hepatic veins is constructed; the fast marching scheme is applied to extract the centerlines. The centerlines of the labeled major veins are extracted by defining the starting and the ending points of each labeled vein. Centerline is extracted by finding the shortest path between the two points. The extracted centerline is used to define the trajectories to plot the required planes between the anatomical segments.
RESULTS: The proposed approach is validated on the IRCAD database. Using visual inspection, the method succeeded to extract the major veins centerlines. Based on that, the anatomic segments are defined according to Couinaud segmental anatomy.
CONCLUSION: Automatic liver segmental anatomy identification assists the surgeons for liver analysis in a robust and reproducible way. The anatomic segments with other liver structures construct a 3D visualization tool that is used by the surgeons to study clearly the liver anatomy and the extension of the cancer inside the liver.

Matched MeSH terms: Hepatic Veins/surgery*
Fulltext Adult-to-adult living donor liver transplantation: Operative techniques to optimize the recipient's outcome

Koh PS, Chan SC

J Nat Sci Biol Med, 2017 Jan-Jun;8(1):4-10.
PMID: 28250667 DOI: 10.4103/0976-9668.198356

Adult-to-adult living donor liver transplantation (LDLT) is widely accepted today with good outcomes and safety reported worldwide for both donor and recipient. Nonetheless, it remained a highly demanding technical and complex surgery if undertaken. The last two decades have seen an increased in adult-to-adult LDLT following our first report of right lobe LDLT in overcoming graft size limitation in adults. In this article, we discussed the operative techniques and challenges of adult right lobe LDLT incorporating the middle hepatic vein, which is practiced in our center for the recipient operation. The various issues and challenges faced by the transplant surgeon in ensuring good recipient outcome are explored and discussed here as well. Hence, it is important to understand that a successful recipient operation is dependent of multifactorial events starting at the preoperative stage of planning, understanding the intraoperative technical challenges and the physiology of flow modulation that goes hand-in-hand with the operation. Therefore, one needs to arm oneself with all the possible knowledge in overcoming these technical challenges and the ability to be flexible and adaptable during LDLT by tailoring the needs of each patient individually.

Matched MeSH terms: Hepatic Veins
Unusual contribution of the first jejunal vein in the formation of the portal vein

Nayak SB, Shetty SD, Packirisamy V, Vasudeva SK

Morphologie, 2021 May 05.
PMID: 33965324 DOI: 10.1016/j.morpho.2021.04.003

Jejunum is drained into superior mesenteric vein through a series of jejunal veins. The way in which the first jejunal vein terminates is of great importance in upper abdominal surgery and radiological procedures. Knowledge of its variations is particularly important in surgical procedures like orthotropic hepatic transplantation, hepatic vein reconstruction, pancreatic surgery and surgical procedures of duodenojejunal junction. We saw a first jejunal vein opening directly into the portal vein. Further, the inferior mesenteric vein drained into the first jejunal vein. This case could be useful to gastroenterologists, general surgeons and radiologists.

Matched MeSH terms: Hepatic Veins