T Benkö1, G Sgourakis2, E P Molmenti3, H O Peitgen4, A Paul1, S Nadalin1,5, T Schroeder6, A Radtke1,5. 1. Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany. 2. Department of Surgery, Furness General Hospital, Dalton Ln, Barrow-in-Furness, Cumbria, LA14 4LF, UK. ggsgourakis@yahoo.gr. 3. Department of Surgery, North Shore University Hospital, Manhasset, NY, USA. 4. MeVis Center for Medical Diagnostic Systems and Visualization, University of Bremen, Bremen, Germany. 5. Department of General, Visceral and Transplant Surgery, University Hospital Tubingen, Tubingen, Germany. 6. Department of Diagnostic and Interventional Radiology, University Hospital Essen, Essen, Germany.
Abstract
OBJECTIVE: The venous vascular anatomy of the caudate lobe is exceptional. The purpose of this study was to assess portal inflow and venous outflow volumes of the caudate lobe. METHODS: Extrahepatic (provided by the first-order branches) versus intrahepatic (provided by the second- to third-order branches) portal inflow, as well as direct (via Spieghel veins) versus indirect (via hepatic veins) venous drainage patterns were analyzed in virtual 3-D liver maps in 140 potential live liver donors. RESULTS: The caudate lobe has a greater intrahepatic than extrahepatic portal inflow volume (mean 55 ± 26 vs. 45 ± 26%: p = 0.0763), and a greater extrahepatic than intrahepatic venous drainage (mean 54-61 vs. 39-46%). Intrahepatic drainage based on mean estimated values showed the following distribution: middle > inferior (accessory) > right > left hepatic vein. CONCLUSIONS: Sacrifice of extrahepatic caudate portal branches can be compensated by the intrahepatic portal supply. The dominant outflow via Spieghel veins and the negligible role of left hepatic vein in caudate venous drainage may suggest reconstruction of caudate outflow via Spieghel veins in instances of extended left hemiliver live donation not inclusive of the middle hepatic vein. The anatomical data and the real implication for living donors must be further verified by clinical studies.
OBJECTIVE: The venous vascular anatomy of the caudate lobe is exceptional. The purpose of this study was to assess portal inflow and venous outflow volumes of the caudate lobe. METHODS: Extrahepatic (provided by the first-order branches) versus intrahepatic (provided by the second- to third-order branches) portal inflow, as well as direct (via Spieghel veins) versus indirect (via hepatic veins) venous drainage patterns were analyzed in virtual 3-D liver maps in 140 potential live liver donors. RESULTS: The caudate lobe has a greater intrahepatic than extrahepatic portal inflow volume (mean 55 ± 26 vs. 45 ± 26%: p = 0.0763), and a greater extrahepatic than intrahepatic venous drainage (mean 54-61 vs. 39-46%). Intrahepatic drainage based on mean estimated values showed the following distribution: middle > inferior (accessory) > right > left hepatic vein. CONCLUSIONS: Sacrifice of extrahepatic caudate portal branches can be compensated by the intrahepatic portal supply. The dominant outflow via Spieghel veins and the negligible role of left hepatic vein in caudate venous drainage may suggest reconstruction of caudate outflow via Spieghel veins in instances of extended left hemiliver live donation not inclusive of the middle hepatic vein. The anatomical data and the real implication for living donors must be further verified by clinical studies.
Authors: Y Sugawara; M Makuuchi; T Takayama; H Imamura; S Dowaki; K Mizuta; H Kawarasaki; K Hashizume Journal: J Am Coll Surg Date: 2001-04 Impact factor: 6.113
Authors: Camino Valentín-Gamazo; Massimo Malagó; Marc Karliova; Juergen T Lutz; Andrea Frilling; Silvio Nadalin; Giuliano Testa; Stefan G Ruehm; Yesim Erim; Andreas Paul; Hauke Lang; Guido Gerken; Christoph E Broelsch Journal: Liver Transpl Date: 2004-09 Impact factor: 5.799
Authors: T Ikegami; T Nishizaki; K Yanaga; M Shimada; S Kakizoe; K Nomoto; S Hiroshige; K Sugimachi Journal: Surgery Date: 2001-01 Impact factor: 3.982
Authors: Tobias Schroeder; Arnold Radtke; Jörg F Debatin; Massimo Malaga; Georgios C Sotiropoulos; Michael Forsting; Hauke Lang; Stefan G Ruehm Journal: Hepatogastroenterology Date: 2007-06
Authors: Jill P J M Hikspoors; Mathijs M J P Peeters; Nutmethee Kruepunga; Hayelom K Mekonen; Greet M C Mommen; S Eleonore Köhler; Wouter H Lamers Journal: Sci Rep Date: 2017-12-07 Impact factor: 4.379