Clinically significant observations of hepatic lobe morphology in adult human cadavers

Abstract

To determine and analyse clinically significant changes in hepatic lobe morphology. An observational study was conducted over 42 adult human livers which were acquired during routine dissections conducted for the first MBBS students over a period of two years (2017-2019) at Dr. PSIMS & RF. Macroscopic thorough examination of the liver specimens was done through borders, surfaces and changes the in parenchymatous tissue was duly documented and photographed. The common finding was prevalence of accessory fissures(50%) followed by pons hepatis (19%) which was identified as bridging the fissure for ligamentum teres(9.5%) and encapsulating the inferior vena cava in 9.5% of liver specimens. Accessory lobes account for a total of 16.6%,with incidence of Riedel's lobe being 7.1%. Tongue like process of left lobe were encountered in 9.5% specimens. Unique finding in the present study was of a liver specimen which had multiple variations on visceral, anterior and superior surfaces. Present study comprised of multiple variations in hepatic lobe morphology, which are of great clinical significance and are interest for radiologists and gastroenterologist. Studies on liver morphology would expand the knowledge for surgical inventions and help in preventing diagnostic errors in imaging techniques.

Morphological Study of Variations of the Human Cadaveric Liver and Its Clinical Implications

“…The RL presented with vascular fissures/Rouviere’s sulcus/fissure of Gans (20% specimens) in our study which bears immense surgical significance in laparoscopic cholecystectomy or segmental resection as it aids in recognition of biliary pedicle [ 1 ]. This has only been reported by a few studies ranging between 4.7% to 27.3% [ 1 , 8 ]. Diagnostic imaging errors can be chiefly attributed to accessory fissures.…”

“…The varying shapes are significant criteria leading to misdiagnoses and unfavorable surgical outcomes [ 4 ]. Clinical challenges can occur with infrequently reported accessory lobes primarily due to being asymptomatic or the presence of Rouviere’s sulcus which has been rarely mentioned by authors [ 7 , 8 ]. Both of these have been reported in this study.…”