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.

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.

FRACTAL PROPERTIES, SEGMENT ANATOMY, AND INTERDEPENDENCE OF THE HUMAN PORTAL VEIN AND THE HEPATIC VEIN IN 3D

Fractals ◽  
2003 ◽  
Vol 11 (01) ◽  
pp. 53-62 ◽  
Author(s):  
HORST K. HAHN ◽  
CARL J. G. EVERTSZ ◽  
HEINZ-OTTO PEITGEN ◽  
JEAN H. D. FASEL
Keyword(s):  
Portal Vein ◽  
Hepatic Vein ◽  
Three Dimensional ◽  
Branching Ratio ◽  
Liver Parenchyma ◽  
Hepatic Veins ◽  
Scaling Properties ◽  
Computed Tomography Images ◽  
Fractal Properties ◽  
Human Livers

The scaling properties of the portal vein and the hepatic vein are examined, based on three-dimensional computed tomography images of casts of human livers. In particular, a quantitative analysis of the branching ratio based on the Strahler ordering scheme as well as the diameter and length ratios are performed. To quantify the segment anatomy of the liver, the volume of supplied liver parenchyma is measured and related to the corresponding vessel radius. The implications of these findings for segment-oriented liver surgery are discussed. We also investigate the 3D interdependence of the intertwined portal and hepatic veins based on a concept of tree distance that will be introduced.

scholarly journals A sonographic Doppler study of the hepatic vein, portal vein and hepatic artery in liver cirrhosis: Correlation of hepatic hemodynamics with clinical Child Pugh score in Singapore

Ultrasound ◽  
2017 ◽  
Vol 25 (4) ◽  
pp. 213-221 ◽  
Author(s):  
Azizah M Afif ◽  
Jason Pik-Eu Chang ◽  
Yan Y Wang ◽  
Simin D Lau ◽  
Fuzhen Deng ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Doppler Ultrasound ◽  
Hepatic Vein ◽  
Imaging Modality ◽  
Resistive Index ◽  
Clinical Score ◽  
Doppler Study ◽  
Hepatic Artery Resistive Index

Objective Liver cirrhosis has been a rising complication of chronic liver disease in Singapore. Ultrasound has been widely accepted as a non-invasive imaging modality for the evaluation of hepatic haemodynamics. This study aims to correlate the Doppler ultrasound values with the progression of liver cirrhosis to allow further understanding and possible prediction of clinical events for timely intervention. Methods Study sample of 56 eligible patients with liver cirrhosis was divided according to their Child-Pugh clinical score into Child’s A (n = 29 patients), B (n = 19 patients) and C (n = 8 patients). The maximum portal vein velocity, maximum hepatic vein velocity, maximum hepatic artery velocity and hepatic artery resistive index were assessed by Doppler ultrasound. Results The incidence of ascites increases with the severity of cirrhosis. Flattening of the hepatic vein waveforms was dependant on degree of liver cirrhosis. Maximum hepatic vein velocity was higher in cirrhotic patients (where p = 0.05). Maximum portal vein velocity was found to be lower in cirrhosis (where p < 0.001) and mean maximum portal vein velocity decreases as severity of cirrhosis worsens. Hepatic artery resistive index was significantly higher in cirrhosis (where p < 0.001). Significant association was found between maximum hepatic vein velocity and maximum hepatic artery velocity and significant negative correlation was observed with the maximum portal vein velocity and hepatic artery resistive index. Conclusion The study demonstrated that these parameters can supplement the evaluation of liver cirrhosis and will be able to distinguish the different grades of liver cirrhosis using Doppler ultrasound.

scholarly journals Non-invasive measurement of hepatic venous oxygen saturation (ShvO2) with quantitative susceptibility mapping in normal mouse liver and livers bearing colorectal metastases

2017 ◽  
Author(s):  
E. Finnerty ◽  
R. Ramasawmy ◽  
J. O’Callaghan ◽  
J. Connell ◽  
M. F. Lythgoe ◽  
...  
Keyword(s):  
Portal Vein ◽  
Oxygen Saturation ◽  
Hepatic Vein ◽  
Animal Studies ◽  
Colorectal Metastases ◽  
Hepatic Veins ◽  
Blood Gas ◽  
National Cancer Research Institute ◽  
Venous Oxygen Saturation ◽  
Hepatic Venous Oxygen Saturation

AbstractPurposeThe purpose of this prospective study was to investigate the potential of QSM to non-invasively measure hepatic venous oxygen saturation (ShvO2).Materials & MethodsAll animal studies were performed in accordance with the UK Home Office Animals Science Procedures Act (1986) and UK National Cancer Research Institute (NCRI) guidelines. QSM data was acquired from a cohort of mice (n=10) under both normoxic (medical air, 21% O2/ balance N), and hyperoxic conditions (100% O2). Susceptibility measurements were taken from large branches of the portal and hepatic vein under each condition and were used to calculate venous oxygen saturation in each vessel. Blood was extracted from the IVC of three mice under norm- and hyperoxic conditions, and oxygen saturation was measured using a blood gas analyser to act as a gold standard. QSM data was also acquired from a cohort of mice bearing colorectal liver metastases (CRLM). SvO2was calculated from susceptibility measurements made in the portal and hepatic veins, and compared to the healthy animals.ResultsSvO2calculated from QSM measurements showed a significant increase of 14.93% in the portal vein (p < 0.05), and an increase of 21.39% in the hepatic vein (p < 0.01). Calculated results showed excellent agreement with those from the blood gas analyser (26.14% increase). ShvO2was significantly lower in the disease cohort (30.18 ± 11.6%), than the healthy animals (52.67 ± 17.8%) (p < 0.05), but differences in the portal vein were not significant.ConclusionQSM is a feasible tool for non-invasively measuring hepatic venous oxygen saturation and can detect differences in oxygen consumption in livers bearing colorectal metastases.

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.

scholarly journals Reconstruction of the middle hepatic vein using a vein graft from the resected portion of the liver

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
ShiWei Yang ◽  
DongDong Han ◽  
Liang Wang ◽  
Lei Gong ◽  
CanHong Xiang
Keyword(s):  
Portal Vein ◽  
Hepatic Vein ◽  
Intrahepatic Cholangiocarcinoma ◽  
Vein Graft ◽  
Critical Role ◽  
Liver Volume ◽  
Middle Hepatic Vein ◽  
Postoperative Liver Failure ◽  
Hepatic Veins ◽  
Left Hepatectomy

Abstract Background The middle hepatic veins are often infiltrated by intrahepatic cholangiocarcinoma. Reconstruction of the hepatic vein plays a critical role in preserving more of the residual liver volume and reducing the risk of postoperative liver failure in extreme hepatectomy. We here report a novel way to reconstruct middle hepatic vein by using vessel grafts from wasted liver. Case presentation Case 1: A 64-year-old man was diagnosed with intrahepatic cholangiocarcinoma. The bifurcation and left branch of the portal vein were stenosed, and the root of the middle hepatic vein was infiltrated by the tumor. An extended left hepatectomy was performed, the portal vein was resected and reconstructed, and the middle hepatic vein was reconstructed by anastomosing the proximal left hepatic vein to the distal middle hepatic vein. Case 2: A 69-year-old woman was diagnosed with intrahepatic cholangiocarcinoma. The tumor was located in the left lobe of the liver and the left and middle hepatic veins were infiltrated by the tumor. An extended left hepatectomy was performed, and the left portal vein was used as a vein graft to reconstruct the middle hepatic vein. Both of the two patients’ postoperative ultrasound showed vessel graft patency. Conclusion Using a vein graft from the resected portion of the liver to reconstruct the middle hepatic vein was a useful technique and showed good result.

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 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.

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