Right hepatic venous system variation in living donors: a three-dimensional CT analysis. Issue 9 (26th April 2020)

• Record Type: Journal Article
• Authors: Watanabe, A; Yoshizumi, T; Harimoto, N; Kogure, K; Ikegami, T; Harada, N; Itoh, S; Takeishi, K; Mano, Y; Yoshiya, S; Morinaga, A; Araki, K; Kubo, N; Mori, M; Shirabe, K
• Is Part Of: British journal of surgery. Volume 107:Issue 9(2020)
• Page Start: 1192
• Page End: 1198
• Publication Date: 2020-04-26
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1002/bjs.11602
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Background: The right hepatic venous system consists of the right hepatic vein (RHV) and inferior RHVs (IRHVs). When the right posterior section is used as a graft for liver transplantation, understanding variations and relationships between the RHV and IRHVs is critical for graft venous return and hepatic vein reconstruction. This study aimed to evaluate variations in the hepatic veins and the relationships between them. Methods: The medical records and CT images of patients who underwent hepatectomy as liver donors were assessed retrospectively. The relationship between the veins was evaluated by three-dimensional CT. Results: The configuration of the posterior section was classified into one of eight types based on the RHV and IRHVs in 307 patients. Type 1a (103 of 307), type 1b (139 of 307) and type 2a (40 of 307) accounted for 91·9 per cent of the total. The diameter of the RHV extending towards the inferior vena cava had a significant inverse correlation with that of the IRHV ( r 2 = –0·615, P < 0·001). Type 1a, which had no IRHVs, had the RHV with the largest diameter; conversely, type 2a, which had a large IRHV, had the RHV with the smallest diameter. Conclusion: The hepatic venous system of the right posterior section was classified into eight types, with an inverse relationship between RHV and IRHV sizes. This information is useful for segment VII resection or when the right liver is used as a transplant graft. Graphical Abstract: This study aimed to clarify variations in the right hepatic vein and inferior right hepatic veins, and to evaluate the relationship between them quantitatively. Understanding the venous configuration can help ensure safe and effective surgery during living donor liver transplantation or hepatectomy. Roadmap for safe surgery