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 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.

scholarly journals Behavior of cholinesterase and liver mitochondrial function in dogs submitted to normothermic ischemia and reperfusion

2003 ◽  
Vol 18 (suppl 5) ◽  
pp. 38-41
Author(s):  
Luis Pinto Fernandes ◽  
Ajith Kumar Sankarankutty ◽  
Eduardo Garcia Pacheco ◽  
Sérgio Centurion ◽  
Maria Cecília Jordani ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Portal Vein ◽  
Hepatic Artery ◽  
Mitochondrial Function ◽  
Inferior Vena ◽  
Vena Cava ◽  
Respiratory Control ◽  
Ischemic Injury ◽  
Sensitive Indicator ◽  
Ischemia And Reperfusion

PURPOSE: The plasmatic activity of the cholinesterase (CHE) and the liver mitochondrial function, expressed by the ratio of respiratory control (RCR), were studied during normothermic ischemia. METHODS: Sixteen adult mongrels, eight females and eight males were submitted to ischemia by clamping of the hepatic artery, portal vein and infrahepatic inferior vena cava, infra-hepatic, for two h, follwed by reperfusion for 1 h. The CHE and the mitochondrial function were evaluated at 60 and 120 min. of ischemia and at 15 and 60 minutes of reperfusion. RESULTS: The CHE decreased, significantly, during ischemia and in reperfusion. The RCR was decreased at 120 min. of ischemia, returning to the initial values on reperfusion. CONCLUSION: In this study, the CHE was a sensitive indicator of ischemic injury , suggesting irreversibility of ischemia injury. The RCR, by other side, showed a greater sensibility than the CHE in detection sense, during the studied period, the reversibility of the hepatic ischemic injury.

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 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.

scholarly journals NUMBER AND PATTERN OF HEPATIC AND ACCESSORY HEPATIC VEINS

2020 ◽  
pp. 1-3
Author(s):  
Manmeet Kour ◽  
Shamima Banoo ◽  
Mohd Saleem Itoo
Keyword(s):  
Postoperative Complications ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Venous Blood ◽  
Vena Cava ◽  
Hepatic Veins ◽  
Surgical Interventions ◽  
Number Pattern ◽  
Dual Blood Supply ◽  
Accessory Hepatic Vein

Introduction: Liver receives dual blood supply from hepatic artery and portal vein. Venous blood from Liver to inferior vena cava is drained by three hepatic veins. The number, pattern and mode of termination of hepatic veins into inferior vena cava is not always same. Variations in number, pattern and positions of the hepatic veins and their mode of termination do exist which significantly influence surgical interventions on liver especially during transplantation. Materials and Methods: 28 wet formalin preserved specimens were taken for the present study. A longitudinal incision was given in the inferior vena cava to observe the number, pattern and arrangement of hepatic veins openings into inferior vena. The specimens were preserved after routine dissection classes Result: 19 livers of 28 (67.86%) were found to be drained by three major hepatic veins, whereas 9 livers out of 28 (32.14) presented with accessory hepatic veins in addition to major hepatic veins. The number of accessory veins ranged from 1-3. Out of the nine specimens with accessory hepatic veins seven (77.77%) presented with three plus one pattern (3 major hepatic veins 1 accessory hepatic vein).Three plus two and three plus three pattern was observed in one specimen each (11.11%). The arrangement of three major veins from left to right was left hepatic, middle hepatic and right hepatic. The openings of all accessory veins were found below the openings of major hepatic veins. Conclusion: A sound knowledge of Accessory hepatic veins and their pattern is essential for Radiologists and also for liver transplant surgeons to reduce postoperative complications.

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.

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