EXTRA-HEPATIC PART OF PORTAL VEIN – A CADAVERIC STUDY IN ADULTS & FOETUSES

Background: Variations of the Hepatic Portal Vein are encountered during abdominal surgeries. Aim: The present study is an observational study of the extrahepatic part of Portal Vein & its variations on cadavers. Materials & Methods: A total of 50 upper abdomen dissections were carried out to delineate extra-hepatic Portal Vein anatomy. The Results: mean length of Portal Vein was 5.96cm. The mean diameter of Portal Vein was 1.35cm. The most common type of formation of Portal Vein was Type I, found in 64%. The Right Gastric Vein commonly emptied into the trunk of the Portal Vein. The Left Gastric Vein commonly emptied into the trunk of the Portal Vein in 87.18%. The most common type of Portal Vein termination was Extra-Hepatic, found in 76% of 50 dissections. The Bifurcation pattern was the most common pattern of Portal Vein termination, found in 94% of dissections. The ndings of the present Conclusion: study highlight the variations that may occur in the hepatic portal venous system in its extra-hepatic part. Sound knowledge of portal venous anatomy is needed for success in the surgeries of the liver & adjacent viscera.

Right Hepatectomy In Patient with Absent Portal Vein Bifurcation

Introduction: Understanding of hepatic vascular anatomy and its variations are crucial for performing liver resection and transplantation. Here we present a case of successful right hepatectomy in the patient with absent portal vein bifurcation. Case presentation: 34 years old female presented for elective right hepatectomy. Preoperative CT scan demonstrated absence of portal vein bifurcation. Right hepatectomy was safely achieved by parenchymal division under ultrasound guidance with preservation of intrahepatic portal branches to left hemiliver and without postoperative complications. Discussion: Normal portal vein anatomy is observed in 65-86% of all cases [1, 2]. Of all portal vein anatomy variations, absence of the portal vein bifurcation is rarest among reported with incidence as low as 0.03% [1]. Conclusion: Preoperative recognition of aberrant portal vein anatomy is important for prevention of life-threatening complications after elective hepatectomy and transplantation.

Analysis of the hepatic vessels structure in potential liver donors

Aim. To analyze anatomic variants of arterial and venous blood supply of liver in potential liver donors by using of CT-angiography (CTA).Material and methods. CTA data of 151 potential donors have been examined for the period 01.01.2016-01.01.2018. Non-ionic iodine-containing (320 mg/ml) contrast agent was used at a dose of 1.4 ml/kg and infusion rate near 4.0 ml/s. Variants of arterial anatomy were classified according to N. Michels, portal vein anatomy — according to T Nakamura classification (2002).Results. N. Michels type I was the most common variant of arterial structure (n = 108, 71.5%). Types II and III were observed in 8.6% and in 7.9% of cases, respectively. Types IV and IX included the same number of donors (2.6%). Types VII and VIII were the rarest (0.7% and 1.3%). Types V, VI, X were absent. There were 7 cases (4.6%) with arterial variants which are not described by N.Michels classification. Moreover, 3 types were not previously described by other authors.Conclusion. Hepatic artery variations coincide with the classification of N. Michels as a rule (95.4%). Other anatomic variants not described in this classification were observed only in 4.6% of cases.

A study on branching pattern of main portal vein

Background: An intimate knowledge and awareness of branching patterns of main portal vein is necessary before hepatic surgeries. The presence of portal vein variants increases the risk of bile duct hilar anatomical variations also. This information may be of help for accurate radiological interpretation, to prevent complications like hemorrhage, difficult anastomosis in the recipient, ischemia in the graft and allograft failure at the time of liver transplantation. Hence the present study was conducted with the objective of observing the branching pattern of the main portal vein, to measure length of right portal vein and angle between right and left portal vein. Material and Methods: The present study was conducted on 84 liver specimens of human cadavers fixed with 5% formalin, collected from the Department of Anatomy and Forensic Medicine, MMC&RI, Mysore. The parameters were measured using image J software. Results: Bifurcation of main portal vein was seen in 75 liver specimens [89.3%]. Trifurcation of main portal vein was seen in 9 specimens [ 10.7%]. Mean angle between Right and left portal vein was 146.7°. Mean length of right portal vein was 2.27 cm. Conclusion: Knowledge of portal vein variations is critically significant in surgical resection and transplantation procedures. Resection of any portion of liver should be well planned and clear identification of sub segments of liver is necessary before surgery. Surgeons and radiologists must have a thorough understanding of variants in portal vein anatomy in order to prevent injury to portal vein and for successful radiological interventions.