Imaging of Hepatic Arterial Anatomy for Depicting Vascular Variations in Living Related Liver Transplant Donor Candidates With Multidetector Computed Tomography: Comparison With Conventional Angiography

Çoşkun, Mehmet; Kayahan, E. M.; Özbek, Orhan; Çakır, Banu; Dalgic, A.; Haberal, Mehmet

doi:10.1016/j.transproceed.2005.01.019

Cited by 57 publications

(44 citation statements)

References 8 publications

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“…be useful during insertion of a TIPS (transjugular intrahepatic portosystemic shunt) [23]. Familiarity with hepatic vein variants is also important for surgical treatment of hepatic disease, especially liver transplantation, where it is essential for preoperative workup and postoperative follow-up of the recipient as well as for assessment of potential donors [7,24,25].…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound examination of the liver: Variations in the vascular anatomy

Battaglia

Fachinetti

Draghi

et al. 2010

Journal of Ultrasound

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The hepatic vasculature is highly complex. The hepatic artery (a branch of the celiac tripod) and the portal vein (formed by the confluence of the splenic and superior mesenteric veins) provide a dual blood supply while venous drainage is guaranteed by the hepatic veins. There are also numerous anatomic variants that can involve one or more of the system's three components.Hepatic artery variants are the least common. Ten types have been identified, including several that are fairly frequent and others that are quite rare, and the variation generally involves the extrahepatic portion of the vessel. Portal vein variants are found in around 20% of the population. They can involve the main portal trunk or segmental branches. Variants of the hepatic veins are the most common. They involve the number and course (supernumerary veins) or the number, course, and openings (accessory veins).Knowledge of portal vein and hepatic vein variants, which are extremely common, is of prime importance for precise localization of lesions. Hepatic artery variants are equally important for surgical treatment of hepatic disease, especially liver transplantation, where it is essential for preoperative workup and postoperative follow-up of the recipient as well as for assessment of potential donors.Sommario La vascolarizzazione del fegato è complessa: arteria epatica, ramo del tripode celiaco, e vena porta, costituita dalla confluenza delle vene splenica e mesenterica superiore, forniscono una doppia vascolarizzazione; mentre il drenaggio è assicurato dalle vene sovrepatiche, inoltre vi è un numero significativo di varianti che possono interessare separatamente o contemporaneamente i tre i sistemi.Le varianti dell'arteria epatica, meno frequenti rispetto alle altre, sono state classificate in dieci tipi di cui alcuni più comuni, altri del tutto eccezionali, riguardano principalmente il tratto extra-epatico del vaso. Quelle della vena porta, che si riscontrano in circa il 20% della popolazione, possono interessare sia i rami principali che i segmentari. Quelle delle vene sovrapatiche, le più frequenti, possono riguardare il numero ed il decorso (vene soprannumerarie) o il numero ed il decorso, ma anche lo sbocco (vene accessorie). La conoscenza delle varianti portali e delle vene sovrepatiche, estremamente frequenti, è di primaria importanza per la possibilità di localizzare con precisione eventuali lesioni; non meno importante è la conoscenza delle varianti dell'arteria epatica, in relazione alle terapie chirurgiche, in particolare per quello che riguarda i trapianti, sia nella fase pre-operatoria, sia nella valutazione del potenziale donatore, sia nel follow-up. ª

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Section: Discussionmentioning

confidence: 99%

“…1) [6,7] and reported their relative frequencies based on the dissection of 200 cadavers. Other variants exist although they are much less common.…”

Section: Hepatic Arterymentioning

confidence: 99%

Ultrasound examination of the liver: Variations in the vascular anatomy

Battaglia

Fachinetti

Draghi

et al. 2010

Journal of Ultrasound

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“…2B) arises from the anterior aspect of the abdominal aorta, right below the diaphragm, and proceeds forward and to the right for approximately 1.5 cm before dividing into the following three branches: the left gastric artery, the hepatic artery ( Fig. 2A), and the splenic artery [5,6].…”

Section: The Hepatic Arterymentioning

confidence: 99%

Ultrasound examination of the liver: Normal vascular anatomy

Draghi

Rapaccini

Fachinetti

et al. 2007

Journal of Ultrasound

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Various treatments for liver diseases, including liver transplant (particularly partial liver resection from a living donor), treatment of liver tumors, and TIPS, require detailed knowledge of the complex vascular anatomy of the liver. The hepatic artery and portal vein provide the organ with a double blood supply whereas venous drainage is furnished by the hepatic veins.Multislice computed tomography and magnetic resonance imaging provide undeniably excellent information on these structures. On ultrasound, the inferior vena cava, the openings of the hepatic veins, and the main branch of the portal vein can always be visualized, but intrasegmental vessels (portal, arterial, accessory hepatic venous branches) can be only partially depicted and in some cases not at all.In spite of its difficulty and limitations, hepatic sonography is frequently unavoidable, particularly in critically ill patients, and the results are essential for defining diagnostic and therapeutic strategies. For this reason, a thorough knowledge of the sonographic features of hepatic vascular anatomy is indispensable.Sommario Vari interventi terapeutici sul fegato, in particolare il trapianto, con maggior rilevanza per la resezione parziale da donatore vivente, il trattamento dei tumori epatici e le TIPS, richiedono la conoscenza dettagliata dell'architettura vascolare epatica, che è complessa; arteria epatica e vena porta forniscono al fegato una doppia vascolarizzazione, mentre il drenaggio venoso è assicurato dalle vene sovrepatiche.TC multistrato e RM forniscono sicuramente dati eccellenti mentre ecograficamente sono costantemente evidenziabili la vena cava inferiore, lo sbocco delle sovrepatiche e i rami principali della vena porta; la vascolarizzazione intrasegmentale (rami portali, rami arteriosi e vene sovrepatiche accessorie) lo è solo parzialmente e saltuariamente.

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“…Bu tip yaralanmalarda cerrahi diseksiyon şeklinin yanında vasküler varyasyonlar da önem arz etmektedir. Literatürde sağ hepatik artere bağlı görülen varyasyon oranlarının %3 ile %15 arasında değiştiği gösterilmiştir (3,4,5). Oluşan vasküler yaralanmalarda karaciğerde iskemik alanların oluşumu ve hatta yaralanmanın kontrolü esnasında çevre dokulara zarar verme ihtimali mevcuttur.…”

Section: Introductionunclassified

Incidentally detected variation of right hepatic artery during laparoscopic cholecyctectomy

Coşkun¹,

Yiğit²,

Meral³

et al. 2013

Gaziantep Med J

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ÖzetGünümüzde karaciğerin vasküler yapısı ve muhtemel varyasyonları bilinmektedir. Ancak cerrahi prosedür esnasında karşılaşılan bu varyasyonlar cerrah için kimi zaman problem oluşturmaktadır. Burada kolelitiazis nedeniyle laparoskopik kolesistektomi uygulanan hastada karşılaştığımız sağ hepatik arter varyasyonunu sunduk. Sık yapılan ameliyatlarda bile operasyon esnasında karşılaşılan anatomik varyasyonların komplikasyon riskini arttırabileceği göz önünde bulundurulmalıdır. Anahtar kelimeler: Kolesistektomi; sağ hepatik arter; varyasyon. Abstract Vascular structures of liver and possible variations are known at the present day. However, during the surgical procedure, these variations can cause problems for the surgeons. We presented a variation of right hepatic artery which was detected incidentally at the operation of laparoscopic cholecyctectomy for cholelitiasis. There is a risk of complications because of anatomic variations which are detected at the common operations. Therefore, these situations should be kept in mind.

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Imaging of Hepatic Arterial Anatomy for Depicting Vascular Variations in Living Related Liver Transplant Donor Candidates With Multidetector Computed Tomography: Comparison With Conventional Angiography

Cited by 57 publications

References 8 publications

Ultrasound examination of the liver: Variations in the vascular anatomy

Ultrasound examination of the liver: Variations in the vascular anatomy

Ultrasound examination of the liver: Normal vascular anatomy

Incidentally detected variation of right hepatic artery during laparoscopic cholecyctectomy

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