Inferior Right Hepatic Vein: A Useful Anatomic Variation for Isolated Resection of Segment VIII

Anatomical resection of segment VIII (SVIII) is one of the most difficult hepatectomies to perform. Although it is the best choice of surgical treatment for tumors located at SVIII, its feasibility can be compromised when the right hepatic vein (RHV) must be resected en bloc with SVIII. Herein we describe a case of a cirrhotic patient that was submitted to segmentectomy VIII in bloc with the main trunk of the RHV, due to hepatocellular carcinoma. The resection could only be performed because a well developed inferior right hepatic vein (IRHV) was present. Anatomical variations of the liver vascularization should be used by liver surgeons to improve surgical results.

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Robotic suture of a large caval injury caused by endo-GIA stapler malfunction during laparoscopic wedge resection of liver segments VII and VIII en-bloc with the right hepatic vein

Minimally Invasive Therapy & Allied Technologies ◽

10.1080/13645700903201001 ◽

2009 ◽

Vol 18 (5) ◽

pp. 306-310 ◽

Cited By ~ 25

Author(s):

Ugo Boggi ◽

Carlo Moretto ◽

Fabio Vistoli ◽

Simone D'Imporzano ◽

Franco Mosca

Keyword(s):

Hepatic Vein ◽

Wedge Resection ◽

En Bloc ◽

Laparoscopic Wedge Resection ◽

The Right ◽

Right Hepatic Vein

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Three-dimensional Computed Tomography Scan Analysis of Anatomical Variations in the Hepatic Veins

International Surgery ◽

10.9738/intsurg-d-16-00077.1 ◽

2016 ◽

Author(s):

Wenli Xu ◽

Chonghui Li ◽

Weidong Duan ◽

Jiahong Dong

Keyword(s):

Hepatic Vein ◽

Malignant Tumors ◽

Liver Volume ◽

Three Dimensional ◽

Anatomical Variations ◽

Hepatic Veins ◽

Common Trunk ◽

Drainage Volume ◽

The Right ◽

Right Hepatic Vein

Abstract Objectives: Hepatic venous anatomy is a significant component of liver segmental anatomy, and its high variability is a challenge for hepatobiliary surgeons. Methods: This was a retrospective study of 98 consecutive patients with no cirrhosis or malignant tumors. IQQA-Liver software was used to display and analyze three-dimensional (3D) images of the hepatic veins and their branches and variations. Results: The average liver volume was 1272.65Â±322.04 ml;the left hepatic veins drained the smallest parts (21.13Â±5.41%) of the liver compared with the right (35.58Â±12.41%) and middle hepatic veins (34.64Â±8.76%). The most common pattern was that the left hepatic veins shared a common trunk with the middle hepatic veins in 51cases (52.0%). The visualization rate of the inferior right hepatic vein (IRHV) was 43.9%, and its drainage volume was 179.27Â±128.79 ml. In 11.2% of patients, the drainage volume for the IRHV was larger than for the right hepatic vein (RHV). The patterns of the left hepatic and middle hepatic veins were also observed and classified. Umbilical hepatic veins appeared in 75cases (76.5%), and anterior fissure hepatic veins appeared in 74 cases (75.5%).The rate of the presence of a separate segment 4 vein was 15.3%, and 77 patients had obvious superficial veins. There was a statistically significant correlation between the diameter of the IRHVs and the drainage volume of the IRHVs and RHVs. Conclusion: More detailed information about the anatomical features and variations of hepatic venous veins in Chinese people was provided using 3D reconstructions, and this will assist in more precise liver surgeries.

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