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- Title
Variations in anatomy of the middle hepatic vein and their impact on formal right hepatectomy.
- Authors
Kamel, I. R.; Lawler, L. P.; Fishman, E. K.
- Abstract
<bold>Background: </bold>We evaluated the incidence of variations of the middle hepatic vein (MHV) branches and their impact on formal right hepatectomy for living-donor liver transplantation.<bold>Methods: </bold>Fifty consecutive patients who underwent hepatic multidetector row computed tomography (CT) were evaluated. Three-dimensional volume rendering techniques were used to evaluate the different branching patterns of the MHV. An incision plane was constructed to simulate a formal hepatectomy along Cantlie's line, immediately to the right of the MHV. The number of transected vessels was recorded by consensus of two observers.<bold>Results: </bold>In 11 patients (22%) the MHV had no major (>5 mm) branches. In 15 patients (30%) a major branch was seen draining the right lobe, and in 10 patients (20%) a major branch was seen draining each lobe. In five patients (10%) two major branches were seen draining the right lobe and a single branch draining the left lobe. The remaining nine patients (18%) had other variations, including one patient (2%) with the right hepatic vein arising from the MHV. A formal hepatectomy along Cantlie's line was truly avascular in 15 patients (30%).<bold>Conclusion: </bold>A formal right hepatectomy can be performed without transecting major branches of the MHV in one-third of patients. In the remaining two-thirds, one or more major branch of the MHV will need be transected. Preoperative knowledge of these variations is critical for surgical planning.
- Subjects
HEPATECTOMY; LIVER surgery; BLOOD vessels; TOMOGRAPHY; MEDICAL radiography; HEPATIC artery
- Publication
Abdominal Imaging, 2003, Vol 28, Issue 5, p668
- ISSN
0942-8925
- Publication type
journal article
- DOI
10.1007/s00261-002-0088-1