Preliminary study of the anatomy of the venous drainage of the intrahepatic and extrahepatic bile ducts and its relevance to the practice of hepatobiliary surgery

Vellar, Ivo D.

doi:10.1046/j.1440-1622.2001.02150.x

Cited by 34 publications

(32 citation statements)

References 9 publications

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“…22 This system runs along the CBD and HA in the arteriobiliary portion of the portal pedicle anterior to the portal vein and is composed of at least one big vessel along the CBD or hepatic artery or both. This system is comparable to the marginal veins described by Vellar 23 and begins from PSPDV and pyloric veins and divides to form a venous network in the hilar plate. This hilar venous network sends branches to the veins of segments adjacent to the hilum like caudate and quadrate lobes.…”

Section: Venous Drainage Of Biliary Tractmentioning

confidence: 64%

“…26 The paracholedochal venous plexus the right gastric vein. 23 In postmortem specimens Vellar 23 has demonstrated retrograde filling of the marginal veins and the venous plexus on the CBD after transecting the CBD and all communicating veins at the upper border of duodenum and suggested that this bidirectional pathway ensures good results seen in end-to-end anastomosis in liver transplantation.…”

Section: Venous Drainage Of Biliary Tractmentioning

confidence: 98%

“…Brief historical review of the earlier reports on the venous drainage of the bile duct was given by Couinaud 22 and Vellar. 23 The veins draining the CBD are arranged in the form of two plexuses. The epicholedochal venous plexus, described by Saint, 24 is a fine reticular plexus on the surface of the bile ducts where as the paracholedochal venous plexus of Petren 25 lies outside the bile ducts and courses parallel to the ducts.…”

Section: Venous Drainage Of Biliary Tractmentioning

confidence: 99%

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Biliary Tract Anatomy and its Relationship with Venous Drainage

Babu¹,

Sharma

2014

Journal of Clinical and Experimental Hepatology

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Portal cavernoma develops as a bunch of hepatopetal collaterals in response to portomesenteric venous obstruction and induces morphological changes in the biliary ducts, referred to as portal cavernoma cholangiopathy. This article briefly reviews the available literature on the vascular supply of the biliary tract in the light of biliary changes induced by portal cavernoma. Literature pertaining to venous drainage of the biliary tract is scanty whereas more attention was focused on the arterial supply probably because of its significant surgical implications in liver transplantation and development of ischemic changes and strictures in the bile duct due to vasculobiliary injuries. Since the general pattern of arterial supply and venous drainage of the bile ducts is quite similar, the arterial supply of the biliary tract is also reviewed. Fine branches from the posterior superior pancreaticoduodenal, retroportal, gastroduodenal, hepatic and cystic arteries form two plexuses to supply the bile ducts. The paracholedochal plexus, as right and left marginal arteries, run along the margins of the bile duct and the reticular epicholedochal plexus lie on the surface. The retropancreatic, hilar and intrahepatic parts of biliary tract has copious supply, but the supraduodenal bile duct has the poorest vascularization and hence susceptible to ischemic changes. Two venous plexuses drain the biliary tract. A fine reticular epicholedochal venous plexus on the wall of the bile duct drains into the paracholedochal venous plexus (also called as marginal veins or parabiliary venous system) which in turn is connected to the posterior superior pancreaticoduodenal vein, gastrocolic trunk, right gastric vein, superior mesenteric vein inferiorly and intrahepatic portal vein branches superiorly. These pericholedochal venous plexuses constitute the porto-portal collaterals and dilate in portomesenteric venous obstruction forming the portal cavernoma. ( J CLIN EXP HEPATOL 2014;4:S18-S26) P ortal cavernoma develops as a bunch of dilated and tortuous hepatopetal collateral venous channels in response to portomesenteric venous obstruction and induces morphological changes in the biliary ducts, referred to as portal biliopathy or portal cavernoma cholagiopathy. Available literature suggest that the venous plexuses draining the bile duct and veins around the head of pancreas act as preferential collateral venous pathways and dilate to form the portal cavernoma. It is believed that anatomically distinct collateral venous channels are available in cases of portal venous obstruction involving portal vein alone or superior mesenteric and splenic veins also. This article is an attempt to review the existing literature on the venous drainage of biliary tract to understand the mechanisms of development of portal cavernoma. Arterial supply of the biliary tract is more extensively studied than the venous drainage and since the general pattern of arterial supply and venous drainage is similar, this article includes the review of arterial supply also. A...

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Section: Venous Drainage Of Biliary Tractmentioning

confidence: 64%

Section: Venous Drainage Of Biliary Tractmentioning

confidence: 98%

Section: Venous Drainage Of Biliary Tractmentioning

confidence: 99%

See 1 more Smart Citation

Biliary Tract Anatomy and its Relationship with Venous Drainage

Babu¹,

Sharma

2014

Journal of Clinical and Experimental Hepatology

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“…The paracholedochal plexus comprises of two veins, the 3 o'clock and 9 o'clock marginal veins, that run parallel to the CBD in the hepatoduodenal ligament, but not in contact with the CBD wall (Figure 1), and are interconnected with multiple large transverse channels. [8][9][10][11] Near the hilum, these marginal veins can enter the hepatic substance, join the right and left branches of portal vein or join the hilar venous plexus. Just below the hilum, the marginal veins are connected to the patent part of portal vein and its tributary, the right gastric vein.…”

mentioning

confidence: 99%

“…The hilar venous plexus can drain into marginal veins of PCD venous plexus, communicate with the veins of caudate lobe and segment IV or drain into sinusoids ( Figure 2). 8,9 The hilar plexus can also directly drain into nearby branches of portal vein via peribiliary venules (Figure 2). 12 Scanning electron microscopy of corrosion casts of the microvascular arrangement of CBD wall in animals and humans has provided evidence for the presence of two more intrinsic vascular plexuses: the subepithelial and intramural venous plexuses which are connected to the ECD and PCD venous plexuses (Figure 3).…”

mentioning

confidence: 99%

Portal Cavernoma Cholangiopathy: An Endoscopic Ultrasound Based Imaging Approach

Sharma

Rameshbabu²

2014

Journal of Clinical and Experimental Hepatology

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In patients with portal cavernoma cholangiopathy (PCC), appearance and location of collateral channels depends on extent and location of occlusive thrombus in the porto-mesenteric venous system. If the porto-mesenteric venous system is occluded near the formation of portal vein, blood tends to flow through collateral channels that form varices in and around the common bile duct. Though endoscopic ultrasound (EUS) is considered the investigative modality of choice for evaluating common bile duct obstruction, its role in evaluating collateral pathways in and around the common bile duct is poorly defined. This article reviews the anatomy, genesis and appearance of these collateral pathways in PCC. EUS identifies different layers of the common bile duct (CBD) wall and, in PCC, where varices are in close contact with or part of these different layers, can establish the relationship between them. Thus, EUS appears to be the investigation of choice for tracing the origin and course of collaterals in PCC. Careful study of varices in the common bile duct wall prior to ERCP for bile duct stones or biliary strictures may help to plan the procedure and to manage anticipated complications such as hemobilia. ( J CLIN EXP HEPATOL 2014;4:S53-S61) B oth porto-systemic and porto-portal collaterals can develop in response to chronic occlusion of the portal venous system. The location and extent of occlusive thrombus in the porto-mesenteric venous system determine the type of collaterals that eventually develop and the direction of collateral flow.

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Angioarchitecture of gallbladder in pig: LM and SEM study on vascular microcorrosion casts

Prozorowska

Jackowiak

2014

Microsc. Res. Tech.

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The study focused on the description of pig gallbladder angioarchitecture, with particular emphasis on the specifics of the course of blood vessels in individual layers of the gallbladder wall. Furthermore, the vascular systems of the pig gallbladder were analyzed in terms of the adaptation of this organ to changes in its volume during cyclical bile storage and discharge. The gallbladder is supplied by the cystic artery, which in the pig represents a mixed pinnate and bipinnate pattern of branching. The light microscopic and scanning electron microscopic observations of three-dimensional vascular corrosion casts showed the presence of two main complex vascular networks in the wall of the gallbladder, one located in the subserosal and the other in the mucosa. The unique features in the pig, connected with the size of the gallbladder, is the well-developed horizontal venous plexus under folds of the mucosa, which is a voluminous reservoir of fluids absorbed from bile and vascular networks around mucous glands. Superficial blood vessels of the gallbladder run in vascular pairs or triads, where a single artery runs between two veins. The structures of blood flow control, that is, venous valves, were observed only in venules of the subserosal plexus. Spatial arrangement of the vascular network in the pig gallbladder shows functional plasticity during changes in gallbladder volume. The course of superficial blood vessels in the well-filled gallbladder is arcuate, while in the empty gallbladder it is undulated or spiral. In the mucosal and intramural vessels the direction of blood vessels may change from perpendicular to oblique.

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Preliminary study of the anatomy of the venous drainage of the intrahepatic and extrahepatic bile ducts and its relevance to the practice of hepatobiliary surgery

Cited by 34 publications

References 9 publications

Biliary Tract Anatomy and its Relationship with Venous Drainage

Biliary Tract Anatomy and its Relationship with Venous Drainage

Portal Cavernoma Cholangiopathy: An Endoscopic Ultrasound Based Imaging Approach

Angioarchitecture of gallbladder in pig: LM and SEM study on vascular microcorrosion casts

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