Anterior fissure of the right liver ? the third door of the liver

“…Cho et al [7,8] advocated the concept of the 'anterior fissure', where the anterior segment is divided into ventral and dorsal subsegments. They also proposed that the anterior fissure coincides with the boundary between the drainage area of the MHV and the right hepatic vein (RHV).…”

Section: Boundary Between the Drainage Areas Of The Middle And Right mentioning

confidence: 99%

Clinical Anatomy of the Liver: Review of the 19th Meeting of the Japanese Research Society of Clinical Anatomy

et al. 2016

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Precise clinical knowledge of liver anatomy is required to safely perform a hepatectomy, for both open and laparoscopic surgery. At the 19th meeting of the Japanese Research Society of Clinical Anatomy (JRSCA), we conducted special symposia on essential issues of liver surgery, such as the history of hepatic segmentation, the glissonean pedicle approach, application of 3-D imaging simulation and fluorescent imaging using indocyanine green solution, a variety of segmentectomies including caudate lobectomy, the associating liver partition and portal vein embolization for stage hepatectomy and harvesting liver grafts for living donor liver transplantation. The present review article provides useful information for liver surgeons and anatomic researchers.

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“…[3][4][5] In addition, Cho et al proposed this anatomical concept for hepatic surgery. 18,19 However, a liver resection based on this concept is impractical because the landmark is diffi cult to identify on the surface of the right anterior sector. In addition, planning the surgical procedure based on the biliary anatomy is important in surgery for hilar cholangiocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

A left hepatectomy and caudate lobectomy combined resection of the ventral segment of the right anterior sector for hilar cholangiocarcinoma — the efficacy of PVE (portal vein embolization) in identifying the hepatic subsegment: Report of a case

et al. 2009

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This report presents a case of a left hepatectomy and a caudate lobectomy combined resection of the ventral segment of the right anterior sector for hilar cholangiocarcinoma using percutaneous transhepatic portal vein embolization (PVE). The patient was a 44-year-old man admitted to a local hospital with obstructive jaundice. He was diagnosed to have hilar cholangiocarcinoma and was referred to the hospital for further treatment. Cholangiography revealed stenosis of the left hepatic duct and the hilar bile ducts. The dorsal branch of the right anterior sector joined the right posterior branch and the tumor did not invade to the confluence of these branches. Arteriography and portography reconstructed by multidetector-raw computed tomography revealed the ventral branches of the right anterior sector, which separately diverged from the other right anterior branches. It was therefore necessary to perform a left hepatectomy and caudate lobectomy combined resection of the ventral segment of the right anterior sector to completely remove the tumor. Portal vein embolization was thus performed on the left portal vein and the ventral branches of the right anterior sector. Intraoperatively, when the hepatic artery was temporally clamped, the demarcation between the ventral segment and the dorsal segment of the right anterior sector could be clearly visualized. The planned surgery was performed safely. This case demonstrates that the utilization of PVE is useful for a difficult and intricate hepatectomy, which requires an accurate identification of a hepatic subsegment.

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Anterior fissure of the right liver ? the third door of the liver

Cited by 47 publications

References 15 publications

Ventral Segment‐Preserving Right Hepatectomy in Patients with Hepatocellular Carcinoma

Ventral Segment‐Preserving Right Hepatectomy in Patients with Hepatocellular Carcinoma

Clinical Anatomy of the Liver: Review of the 19th Meeting of the Japanese Research Society of Clinical Anatomy

A left hepatectomy and caudate lobectomy combined resection of the ventral segment of the right anterior sector for hilar cholangiocarcinoma — the efficacy of PVE (portal vein embolization) in identifying the hepatic subsegment: Report of a case

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