Anatomical variations in the pattern of the right hepatic veins: possibilities for type classification

Abstract

A morphological study of the right hepatic veins (RHVv) was conducted based on the shape and the confluence pattern of the superior right hepatic vein (SRHV) and the presence of accessory right hepatic veins. The study was performed in 110 undamaged, randomly selected, cadaveric human livers prepared using the corrosion cast methodology. The principles for classifying the RHVv into types were as follows : the length of the vein trunk, the confluence of 2 or 3 main tributaries that form a trunk, and the accessory right hepatic veins that modify the venous drainage of the right side of the liver. Four types of SRHV were identified. Type 1 (20 %), type 2 (40 %) and type 3 (25 %) were the most common, while type 4 (15 %) was linked to the accessory right hepatic veins in cases where they drain a surgically important part of the liver. Accessory right hepatic veins were found in a total of 31 casts (28 %). The hepatocaval confluence was studied and the tributary-free part of the SRHV trunk before it entered the inferior vena cava was measured. The tributary-free part of the SRHV was longer than 1 cm in 77 % of the casts. Anastomoses between the terminal tributaries of the veins involved in the drainage of the right side of the liver were also investigated.

Efficacy and Safety of Right Hemihepatectomy Through the Right Retrohepatic Tunnel

“…The avascular ''tunnel'' contains, on average, 3.7 SHVs which are relatively small (between 0.2 and 0.3 cm in diameter). Compared to other authors' reports [10][11][12][13], the number of SHVs in our group was smaller. Still, a special attention must be paid to the dissection of retrohepatic space; specifically, if the surgeon's assistant ignorantly rotates the right liver and tears SHVs or if the surgeon accidentally pierces RHICV, copious bleeding or air embolism will spontaneously occur.…”

Branching Patterns and Drainage Territories of the Middle Hepatic Vein in Computer-Simulated Right Living-Donor Hepatectomies

“…The right hepatic vein (RHV) usually has the largest drainage area of all three veins, is subject to important variations in hepatovenous anatomy and has been focussed on in separate studies (12,32). Accessory retrohepatic veins (Masselot and Leborgne), also named paracaval (Gupta and Gupta) or medial and inferior RHVs (Couinaud), are found frequently and drain directly into the caval vein.…”

Pattern of branching of the left portal vein: an anatomo-radiological study

“…The difference between the data of vascular casts and radiologic studies is due to the greater accuracy of the anatomical model and because its analysis is more manageable. In fact, the hepatic vasculatures are usually studied on vascular casts [7,9,15,19,27]. Also the spatial boundaries between the segments can be appreciated in the vascular casts [12,[20][21][22]38].…”