BACKGROUND: The liver donor shortage and the higher demand on liver transplantation led to advanced liver surgery techniques in order to better utilization of the cadaveric liver donors. That is why the split-liver technique had been applicated in liver transplantation where the liver after been divided into two lobes would be implanted in two recipients. AIMS: This paper has the goal of study both the extra-hepatic arterial distribuition and anatomie of the liver with application on the split-liver transplantation separating the liver in right and left hepatic lobe. PATIENTS AND METHODS: The authors studied 60 livers from fresh cadaver looking at hepatic artery and its main anatomic variations correlating with split-liver surgery. The liver was split into two portions, right and left lobe. RESULTS: The total liver weight was 1536 +/- 361,8 g, right hepatic lobe 890,3 +/- 230,9 g and left hepatic lobe 649,3 +/- 172,6 g. Common hepatic trunk was found in one (1,6%) case and came from superior mesenteric artery and in another one (1,6%), both left hepatic artery and left gastric artery came from the abdominal aorta. The right hepatic artery raised from celiac trunk in 44 (73,3%) cases, and in 15 (25%) from superior mesenteric artery it was acessory in 11 (18,3%) cases and dominant in 4 (6,6%). The left hepatic artery was acessory of left gastric artery in 2 (3,3%) cases. Hepatic artery trifurcation was found in 9 (15%) cases out of this 6 (10%) to segment IV, 2 (3,3%) to segment III and 1 (1,6%) to segment II. Also we found 2 (3,3%) medium hepatic artery to segment IV. CONCLUSION: Hepatic artery variations allowed liver section into right and left hepatic lobe.
BACKGROUND: The liver donor shortage and the higher demand on liver transplantation led to advanced liver surgery techniques in order to better utilization of the cadaveric liver donors. That is why the split-liver technique had been applicated in liver transplantation where the liver after been divided into two lobes would be implanted in two recipients. AIMS: This paper has the goal of study both the extra-hepatic arterial distribuition and anatomie of the liver with application on the split-liver transplantation separating the liver in right and left hepatic lobe. PATIENTS AND METHODS: The authors studied 60 livers from fresh cadaver looking at hepatic artery and its main anatomic variations correlating with split-liver surgery. The liver was split into two portions, right and left lobe. RESULTS: The total liver weight was 1536 +/- 361,8 g, right hepatic lobe 890,3 +/- 230,9 g and left hepatic lobe 649,3 +/- 172,6 g. Common hepatic trunk was found in one (1,6%) case and came from superior mesenteric artery and in another one (1,6%), both left hepatic artery and left gastric artery came from the abdominal aorta. The right hepatic artery raised from celiac trunk in 44 (73,3%) cases, and in 15 (25%) from superior mesenteric artery it was acessory in 11 (18,3%) cases and dominant in 4 (6,6%). The left hepatic artery was acessory of left gastric artery in 2 (3,3%) cases. Hepatic artery trifurcation was found in 9 (15%) cases out of this 6 (10%) to segment IV, 2 (3,3%) to segment III and 1 (1,6%) to segment II. Also we found 2 (3,3%) medium hepatic artery to segment IV. CONCLUSION: Hepatic artery variations allowed liver section into right and left hepatic lobe.
Authors: Guido Vieira Gomes; Carlos Augusto Cáceres Encina; Felipe Borelli Del Guerra; Guilherne Napoleão Lira; João Luiz Itagiba Fonseca; Junio Pereira Pardins Journal: Arq Bras Cir Dig Date: 2014 Nov-Dec