scholarly journals The anatomy and physiology of the liver

1837 ◽  
Vol 3 ◽  
pp. 211-212
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
External Surface ◽  
Hepatic Duct ◽  
Hepatic Veins ◽  
Short Account ◽  
Anatomy And Physiology ◽  
Mixed Blood ◽  
Portal Veins ◽  
Vena Portae

After giving a short account of the descriptions of Malpighi and other writers respecting the minute structure of the liver, the author proceeds to state the results of his own investigations on this subject. The hepatic veins, together with the lobules which surround them, resemble in their arrangement the branches and leaves of a tree; the substance of the lobules being disposed around the minute branches of the v ins like the parenchyma of a leaf around its fibres. The hepatic veins may be divided into two classes: namely, those contained in the lobules, and those contained in canals formed by the lobules. The first class, is composed of interlobular branches, one of which occupies the centre of each lobule, and receives the blood from aplexus formed in the lobule by the portal vein; and the second class of hepatic veins is composed of all those vessels contained in canals formed by the lobules, and including numerous small branches, as well as the large trunks terminating in the inferior cava. The external surface of every lobule is covered by an expansion of Glisson’s capsule, by which it is connected to, as well as separated from, the contiguous lobules, and in which branches of the hepatic duct, portal veins and hepatic artery ramify. The ultimate branches of the hepatic artery terminate in the branches of the portal vein, where the blood they respectively contain is mixed together, and from which mixed blood the bile is secreted by the lobules, and conveyed away by the hepatic ducts which accompany the portal veins in their principal ramifications. The remaining blood is returned to the heart by the hepatic veins, the beginnings of which occupy the centre of each lobule, and when collected into trunks pour their contents into the inferior cava. Hence the blood which has circulated through the liver, and has thereby lost its arterial character, is, in common with that which is returning from the other abdominal viscera, poured into the vena portae, and contributes its share in furnishing materials for the biliary secretion. The paper is accompanied by numerous drawings of preparations made by the author, of the minute structure of the liver, in which the different sets of vessels and ducts were injected in various ways. The Society then adjourned over the Long Vacation to the 21st of November next.

The Glissonian Approach of the Hilum

Swiss Surgery ◽  
1999 ◽  
Vol 5 (3) ◽  
pp. 143-146 ◽  
Author(s):  
Launois ◽  
Maddern ◽  
Tay
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Posterior Approach ◽  
Hepatic Duct ◽  
Rapid Evolution ◽  
Hepatic Tissue ◽  
Detailed Knowledge ◽  
Porta Hepatis ◽  
Liver Segment ◽  
Glissonian Approach

The detailed knowledge of the segmental anatomy of the liver has led to a rapid evolution in resectional surgery based on the intrahepatic distribution of the portal trinity (the hepatic artery, hepatic duct and portal vein). The classical intrafascial or extrahepatic approach is to isolate the appropriate branch of the portal vein, hepatic artery and the hepatic duct, outside the liver substance. Another method, the extrafascial approach, is to dissect the whole sheath of the pedicle directly after division of a substantial amount of the hepatic tissue to reach the pedicle, which is surrounded by a sheath, derived from Glisson's capsule. This Glissonian sheath encloses the portal trinity. In the transfissural or intrahepatic approach, these sheaths can be approached either anteriorly (after division of the main, right or umbilical fissure) or posteriorly from behind the porta hepatis. We describe the technique for approaching the Glissonian sheath and hence the hepatic pedicle structures and their branches by the intrahepatic posterior approach that allows early delineation of the liver segment without the need for ancillary techniques. In addition, the indications for the use of this technique in the technical and oncologic settings are also discussed.

scholarly journals Vascular Involvements in Cholangiocarcinoma: Tips and Tricks

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3735
Author(s):  
Roberta Angelico ◽  
Bruno Sensi ◽  
Alessandro Parente ◽  
Leandro Siragusa ◽  
Carlo Gazia ◽  
...  
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Vena Cava ◽  
High Volume ◽  
Vascular Reconstruction ◽  
Ex Situ ◽  
Vascular Involvement ◽  
Hepatic Veins ◽  
Hepatic Artery Resection ◽  
Artery Resection

Cholangiocarcinoma (CCA) is an aggressive malignancy of the biliary tract. To date, surgical treatment remains the only hope for definitive cure of CCA patients. Involvement of major vascular structures was traditionally considered a contraindication for resection. Nowadays, selected cases of CCA with vascular involvement can be successfully approached. Intrahepatic CCA often involves the major hepatic veins or the inferior vena cava and might necessitate complete vascular exclusion, in situ hypothermic perfusion, ex situ surgery and reconstruction with autologous, heterologous or synthetic grafts. Hilar CCA more frequently involves the portal vein and hepatic artery. Resection and reconstruction of the portal vein is now considered a relatively safe and beneficial technique, and it is accepted as a standard option either with direct anastomosis or jump grafts. However, hepatic artery resection remains controversial; despite accumulating positive reports, the procedure remains technically challenging with increased rates of morbidity. When arterial reconstruction is not possible, arterio-portal shunting may offer salvage, while sometimes an efficient collateral system could bypass the need for arterial reconstructions. Keys to achieve success are represented by accurate selection of patients in high-volume referral centres, adequate technical skills and eclectic knowledge of the various possibilities for vascular reconstruction.

scholarly journals Arteriovenous Fistula Between the Hepatic Artery and the Hepatic Vein

HPB Surgery ◽  
1989 ◽  
Vol 1 (2) ◽  
pp. 155-160 ◽  
Author(s):  
John M. Howard ◽  
M. Malafa ◽  
Robert J. Coombs ◽  
Anthony M. Iannone
Keyword(s):  
Portal Vein ◽  
Arteriovenous Fistula ◽  
Hepatic Artery ◽  
Hepatic Vein ◽  
Vascular Anomalies ◽  
Celiac Axis ◽  
Hepatic Veins

A patient is presented with multiple vascular anomalies in the branches of the celiac axis as well as in the portal vein and its branches. Apparently, unique in the literature is the presence of a large arteriovenous fistula between the hepatic artery and one of the hepatic veins. The anomalies are presumed to be congenital in origin.

Parathyroid hormone and calcitonin may modulate hepatic IGF-I production in calves

1990 ◽  
Vol 123 (4) ◽  
pp. 471-475 ◽  
Author(s):  
Véronique Coxam ◽  
Marie-Jeanne Davicco ◽  
Denis Durand ◽  
Dominique Bauchart ◽  
Jean-Pierre Barlet
Keyword(s):  
Blood Flow ◽  
Parathyroid Hormone ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Latin Square ◽  
Inorganic Phosphorus ◽  
Hepatic Veins ◽  
Igf I ◽  
Plasma Gh ◽  
Synthetic Salmon Calcitonin

Abstract. Four young milk-fed calves were fitted with catheters chronically implanted in the mesenteric, portal and hepatic veins and in the hepatic artery, and with electromagnetic blood flow probes in the portal vein and hepatic artery, allowing continuous measurement of IGF-I hepatic production. According to a latin square design, these calves received iv mesenteric infusion of calcium (Ca2+; 5 mg/kg) or synthetic salmon calcitonin (sCT; 1 μg/kg), or synthetic bovine parathyroid hormone (1-34) (bPTH; 1 μg/kg), or solvent alone (1.2 ml/kg). Ca2+, sCT or bPTH had no significant effect on portal vein or hepatic artery blood flow. Hypercalcemia observed following Ca2+ infusion did not significantly modify hepatic IGF-I production. sCT decreased plasma Ca2+, inorganic phosphorus and GH concentrations and hepatic IGF-I production. bPTH induced a slight hypercalcemia and hypophosphatemia. It had no significant effect on plasma GH concentration, but increased significantly hepatic IGF-I production. Thus, the anabolic effects of PTH on bone may be partly mediated through an increase in hepatic IGF-I production.

Hepatic capillary pressure is estimated using triple vascular occlusion method in isolated canine liver

1996 ◽  
Vol 271 (5) ◽  
pp. R1130-R1141 ◽  
Author(s):  
T. Shibamoto ◽  
H. G. Wang ◽  
S. Tanaka ◽  
S. Koyama
Keyword(s):  
Portal Vein ◽  
Capillary Pressure ◽  
Hepatic Artery ◽  
Vascular Resistance ◽  
Gravimetric Method ◽  
Vascular Occlusion ◽  
Liver Weight ◽  
Hepatic Veins ◽  
Hepatic Hemodynamics ◽  
Hepatic Volume

We determined whether the triple vascular occlusion pressure (Pto), the equilibration pressure obtained when the hepatic artery, portal, and hepatic veins were occluded simultaneously, represented the capillary pressure (Pc) in isolated bivascularly blood-perfused canine livers. Effects of a bolus injection of histamine (0.1-60 micrograms), norepinephrine (NE; 1-600 micrograms), or acetylcholine (ACh; 0.01-10 micrograms) into the portal vein or the hepatic artery were also studied on vascular resistance distribution using Pto as a measure of Pc. The livers were perfused at constant flow via the portal vein and at constant pressure via the hepatic artery. Pto was compared with Pc measured using the traditional gravimetric method (Pc,i). Pto and Pc,i showed a strong correlation (Pto = -0.02 + 0.98 Pc,i; r = 0.83, P = 0.0018). With comparisons, the intercept was not significantly different from zero, and the slope was not different from 1.00, indicating that Pto accurately represented Pc. The resting postsinusoidal vascular resistance comprised 54% of the total hepatic vascular resistance (Rt). Portal or arterial injection of histamine increased predominantly hepatic venous resistance (Rhv) over portal resistance with liver weight gain. NE constricted both the portal vein and the hepatic artery in greater magnitude than the hepatic vein, as evidenced by a significant decrease in the Rhv/Rt ratio. This precapillary constriction was accompanied by a significant decrease in liver weight. In contrast, ACh contracted both portal and hepatic veins similarly without liver weight change. We conclude that Pto is an excellent estimate of Pc in isolated blood-perfused canine livers and that the hepatic vascular resistance sites in the resting states are located evenly in the pre- and postsinusoidal vessels. Intraportal or intra-arterial infusion of histamine, NE, and ACh produced characteristically different changes in hepatic vascular resistances and hepatic volume. The Pto technique could be applied in experimental research on hepatic hemodynamics.

scholarly journals Surgical Anatomy of the liver

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Alex Emmanuel Elobu 1 ◽  
Vianney Kweyamba 1 ◽  
Rakesh Rai 2
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Inferior Vena ◽  
Anatomical Variations ◽  
Surgical Anatomy ◽  
Hepatic Veins ◽  
Critical Importance ◽  
Liver Anatomy ◽  
Human Organ ◽  
Dual Blood Supply

The liver is the second largest human organ and has got a complex internal vascular and ductal anatomy. It is subdivided into lobes, sections and segments and receives dual blood supply from the hepatic artery and portal vein. The hepatic veins drain the liver directly into the inferior vena to which the liver is intimately related. Anatomical variations are common. A thorough knowledge of the liver anatomy and its variations is of critical importance for safe and successful procedures and surgeries involving the liver.

scholarly journals DISTRIBUTION OF THE HEPATIC BLOOD VESSELS OF THE GROUND SQUIRREL (SPERMOPHILUS CITELLUS)

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Miloš BLAGOJEVIĆ ◽  
Ivana NEŠIĆ ◽  
Milena ĐORĐEVIĆ ◽  
Drago NEDIĆ ◽  
Marija ZDRAVKOVIĆ ◽  
...  
Keyword(s):  
Portal Vein ◽  
Blood Vessels ◽  
Hepatic Artery ◽  
Ground Squirrel ◽  
Vena Cava ◽  
Celiac Artery ◽  
Ground Squirrels ◽  
Hepatic Veins ◽  
Arterial Blood ◽  
Spermophilus Citellus

The aim of this paper was to study distribution of the hepatic artery and portal vein of theportal system of the liver in ground squirrels (Spermophilus citellus) and compare these data withthose concerning the rats, rabbits, guinea pigs and nutrias. The liver of the ground squirrel receivesthe oxygen and nutrients through blood from two large blood vessels: portal vein and hepatic artery(a. hepatica propria). The portal vein is formed by the confluence of three main venous bloodvessels: v. gastropancreaticoduodenalis, v. gastrolienalis and v. mesenterica cranialis. It collectsvenous blood from the stomach, pancreas, spleen and all of intestines except the rectum. The portalvein enters the porta hepatis on the liver together with the hepatic artery. Five venous branches ofdifferent size separate from the portal vein and ramify into the respective liver lobes.Blood leaves the liver through the hepatic veins that start with the central veins. Three large hepaticveins and two venous trunks drain lobes of the liver and enter the caudal vena cava as it passesthrough the liver.A. hepatica propria supplies the liver and gallbladder with oxygenated blood. It raises from thehepatic artery (a. hepatica) wich is the third branch of the celiac artery. A. hepatica propria in theportal fissure is divided into two branches, of which the left branch brings arterial blood to the lefthepatic lobe, and the right branch brings it into other liver lobes.

Portal hypertension

2011 ◽  
Author(s):  
R. Mark Beattie ◽  
Anil Dhawan ◽  
John W.L. Puntis
Keyword(s):  
Blood Pressure ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Pressure Gradient ◽  
Portal Tract ◽  
Hepatic Veins ◽  
Portal Venous System ◽  
Gi Tract ◽  
Portal Veins ◽  
Small Channels

Definition 488Pathophysiology 488Clinical features 489Causes 490Investigations 491Management 492Portal hypertension is increased blood pressure within the portal venous system and defined as an increase in the pressure gradient between the portal veins and the hepatic veins (>5 mmHg).The portal vein carries nutrient-rich blood to the liver from the GI tract and spleen. At the hilum of the liver it divides into the major right and left portal veins. Within the liver these veins undergo further divisions to supply each segment, and terminate in small branches, which pierce the limiting plate of the portal tract and enter the hepatic sinusoids through small channels (...

The influence of parathyroid hormone-related protein on hepatic IGF-1 production

1992 ◽  
Vol 126 (5) ◽  
pp. 430-433 ◽  
Author(s):  
Véronique Coxam ◽  
Marie-Jeanne Davicco ◽  
Denis Durand ◽  
Dominique Bauchart ◽  
Jacques Lefaivre ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Continuous Measurement ◽  
Latin Square ◽  
Hepatic Veins ◽  
Synthetic Analogue ◽  
Related Protein ◽  
Blood Flows ◽  
Parathyroid Hormone Related Protein

Four young milk-fed calves were fitted with catheters chronically implanted in the mesenteric, portal and hepatic veins and in the hepatic artery. Electromagnetic blood flow probes in the portal vein and hepatic artery allowed continuous measurement of hepatic IGF-1 production. In accordance with a latin square design these calves received iv mesenteric infusion (for 60 min) of calcium (Ca, 0.125 mmol·kg body wt−1), the synthetic human parathyroid hormone-related protein (1–34) fragment (PTHrP, 1 nmol·kg body wt−1), the synthetic analogue [tyr] 34-bovine PTH-(7–34) NH2 (2 nmol·kg body wt −1) and PTHrP (1 nmol ·kg body wt −1) or solvent alone (1.2 ml·kg body wt −1 ). Hypercalcaemia observed following Ca infusion had no significant effect on hepatic IGF-1 production. PTHrP induced a slight but significant increase in plasma Ca and IGF-1 concentrations measured in the hepatic vein, without changing blood flows measured in the hepatic artery and portal vein. Thus PTHrP increased hepatic IGF-1 production (15.1±2.7 nmol·6 h−1·kg body wt−1 vs 4±1.3 nmol·6 h−1·kg body wt−1 in controls; p <0.05). These effects induced by PTHrP were inhibited by the synthetic analogue [tyr]34bPTH-(7–34) NH2.

In Vivo Microscopy of the Liver after Injection of Lipiodol into the Hepatic Artery and Portal Vein in the Rat

1989 ◽  
Vol 30 (4) ◽  
pp. 419-425 ◽  
Author(s):  
Z. Kan ◽  
K. Ivancev ◽  
I. Hägerstrand ◽  
V. P. Chuang ◽  
A. Lunderquist
Keyword(s):  
Portal Vein ◽  
Hepatic Artery ◽  
Clinical Significance ◽  
Systemic Circulation ◽  
Hepatic Veins ◽  
In Vivo Microscopy ◽  
Oil Droplets ◽  
Hepatic Microcirculation ◽  
The Subject

The route, distribution and clearance of intraarterially administered Lipiodol in the liver has been the subject of much speculation. The hepatic microcirculation was therefore studied by in vivo microscopy after injection of Lipiodol into the hepatic artery and the portal vein in rats. After intraarterial injection, Lipiodol rapidly entered the portal branches through arterio-portal communications. Lipiodol also passed through the sinusoids from the portal into the hepatic veins and then into the systemic circulation. Sinusoidal congestion occurred when the oil droplets filled the liver microcirculation and resolved as the oil was cleared. It is of clinical significance to note the passage of the oil into the systemic circulation after arterial injection.

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