Porta Hepatis in Normal Liver

Dimpy Gupta, Priyanka N Sharma, Achleshwar Gandotra

Abstract


Background: Hepatic surgery requires comprehensive knowledge of structures passing through porta hepatis. This fact prompted us to undertake the study of porta hepatis (PH). Our aim was to find out the dimensions, shape of porta hepatis and the numerical variations of structures passing through it.

Material and Methods: This study was carried out on 25 adult cadaveric formalin preserved human liver. The porta hepatis was identified and its transverse diameter, maximum anteroposterior diameter, various parts of liver contributing in its formation and total circumference were measured using Digital Sliding Vernier Caliper, thread and scale. Number of arteries, veins and ducts passing through it were observed.

Observations and Results: The mean transverse diameter, anteroposterior diameter and total circumference of porta hepatis was 3.80 ± 1.03 cm, 1.79 ± 0.43 cm and 13.61 ± 1.92 cm respectively. Maximum contribution to the circumference of PH was made by caudate process (18.8%) and minimum by fossa for gall bladder (13.1%). 8 specimen showed presence of 2 arteries, 1 vein and 1 duct at porta hepatis. Maximum number of arteries, veins and ducts passing through PH were 5, 3 and 3 respectively in one specimen each. In most of the cases the shape of porta hepatis was triangular.

Conclusion: The dimensions and shape of porta hepatis; arrangement and number of structures at it is highly variable and hence its knowledge can be of great importance to hepato-billiary surgeons.


Keywords


Porta Hepatis; Caudate process; Fossa for gall bladder; Hepatic surgery

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References


Vachhani PG, Copelan A, Remer EM, Kapoor B. Iatrogenic Hepatopancreaticobiliary Injuries: A Review. Semin Interv Radiol. 2015 Jun;32(2):182–94.

Davidoff AM, Pappas TN, Murray EA, Hilleren DJ, Johnson RD, Baker ME, et al. Mechanisms of major biliary injury during laparoscopic cholecystectomy. Ann Surg. 1992 Mar;215(3):196–202.

Grat M, Grzegorczyk K, Lewandowski Z, Sujecki D, Szwedowski D, Boltuc A, et al. Intraoperative injuries during liver resection: analysis of 1,005 procedures. Hepatol Int. 2011 Jun 14;6(2):498–504.

Bismuth H, Majno PE. Hepatobiliary surgery. J Hepatol. 2000 Jan 1;32(1):208–24.

Covey AM, Brody LA, Maluccio MA, Getrajdman GI, Brown KT. Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients. Radiology. 2002 Aug;224(2):542–7.

Covey AM, Brody LA, Getrajdman GI, Sofocleous CT, Brown KT. Incidence, patterns, and clinical relevance of variant portal vein anatomy. AJR Am J Roentgenol. 2004 Oct;183(4):1055–64.

Abdullah SS, Mabrut J-Y, Garbit V, Roche EDL, Olagne E, Rode A, et al. Anatomical variations of the hepatic artery: study of 932 cases in liver transplantation. Surg Radiol Anat. 2006 Oct 1;28(5):468–73.

Chaib E. Absence of bifurcation of the portal vein. Surg Radiol Anat SRA. 2009 Jun;31(5):389–92.

Lyu S-Y, Kuang-Tse Pan, Sung-Yu Chu, Ming-Yi Hsu, Chien-Ming Chen, Chien-Fu Hung, et al. Common and rare variants of the biliary tree: Magnetic resonance cholangiographic findings and clinical implications. ResearchGate. 2012;37(2):59–67.

Nigam GL, Lalwani R, Agrawal D, Chauhan K. Evaluation Of Branching Pattern Of Hepatic Artery. Internet J Gastroenterol [Internet]. 2012 Jan 24 [cited 2017 Feb 13];11(1). Available from: http://ispub.com/IJGE/11/1/13847.

Thungsuppawattanakit P, Arjhansiri K. Anatomic variants of intrahepatic bile ducts in Thais. Asian Biomed. 2012;6(1):51–7.

Kamath. B. K. A study of variant hepatic arterial anatomy and its relevance in current surgical practice. Int J Anat Res. 2015 Mar 31;3(1):947–53.

Raut RS, Bahetee BH. Study of Anatomical Dimensions of Portal Vein. Sch J Appl Med Sci. 2015;3(3E):1343–5.

Sapna M, Shetty SD, Nayak S. A Study on the Number and Arrangement of the Structures Passing Through the Porta Hepatis in South Indian Population. Int J Morphol. 2015;33(1):164–168.

McArthur MS, Hiatt J, Bastounis EA. The surgical anatomy of the porta hepatis. J Surg Res. 1974 Aug 1;17(2):111–3.

Pitchumoni CS. Increasing Prevalence of Gallstones; Diagnostic and Therapeutic Options. Med Update. 2010;20:486–90.

Mokdad AA, Lopez AD, Shahraz S, Lozano R, Mokdad AH, Stanaway J, et al. Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis. BMC Med. 2014;12:145.

Tirumani SH, Prasad Shanbhogue AK, Vikram R, Prasad SR, Menias CO. Imaging of the Porta Hepatis: Spectrum of Disease. RadioGraphics. 2014 Jan 1;34(1):73–92.

Turner MA, Fulcher AS. The Cystic Duct: Normal Anatomy and Disease Processes. RadioGraphics. 2001 Jan 1;21(1):3–22.




DOI: http://dx.doi.org/10.7439/ijbar.v8i3.3956

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