IJAR.2018.299

Type of Article:  Original Research

Volume 6; Issue 3.3 (Septmber 2018)

Page No.: 5637-5642

DOI: https://dx.doi.org/10.16965/ijar.2018.299

A STUDY ON TYPE OF BRANCHING PATTERNS OF RIGHT PORTAL VEIN

Chaitra BR *1, Seema Deepak 2, Dakshayani KR 3.

*1 Assistant Professor, Department of Anatomy, Akash Institute of Medical Sciences and Research Center, Bengaluru rural, Karnataka, India.

2 Professor, Department of Anatomy, Mysore Medical College and Research Institute, Mysore, Karnataka, India.

3 Professor and HOD, Department of Anatomy, Mysore Medical College and Research Institute, Mysore, Karnataka, India.

Corresponding Author: Dr. Chaitra BR, Assistant Professor, Department of Anatomy, Akash Institute of Medical Sciences and Research Center, Devanahalli, Bangalore, Karnataka, India. Pin. 562110. Ph.no. 09916625845. E-Mail: drchaitrabr@gmail.com

ABSTRACT:

Introduction: The right hepatic lobe transplantation is usually the procedure of choice to provide adequate liver volume to the recipient. Variant vascular and biliary anatomy is more common in the right lobe. Knowledge of anatomical variants is valuable in preoperative planning, particularly in considering donor candidates for adult-to-adult liver transplantation, whereby typically the right lobe of the donor is transplanted to the recipient. The present study was done to identify the branching patterns of right portal vein and to know their importance in management of living donor liver transplantation surgeries.

Material and Methods: The present study was conducted on 84 liver specimens of human cadavers fixed with 10% formalin, collected from the Department of Anatomy and Forensic Medicine, MMC&RI, Mysore.

Results: Bifurcation of RPV was seen in 30 specimens (35.7%). Trifurcation of RPV was seen in 5 specimens (6%). Quadrification of RPV was seen in 18 specimens (21.4%). Arched pattern of RPV was seen in 15 specimens (17.9%). Premature origin of segment V and segment VIII vein from RPV, then trunk of RPV dividing terminally into segment VI and segment VII vein was seen in 2 specimens (2.4%). Unusual pattern of division of RPV was seen in 10 specimens (12%). In rest of 4 specimens there was no RPV as Right anterior and Right posterior portal veins were directly arising from Main portal vein.

Conclusion: Anatomical variations of the liver vasculature and bile ducts are common and their recognition and management is critical in living donor liver transplantation. Although anomalies of the right lobe are commonly encountered, a relatively limited number of cases will significantly complicate the resection and transplantation. Main advantage of right lobe transplantation is the large size of graft and surgical management of both donor and recipient anatomical variations is considerably simpler than with left sided graft.

Key words: Liver transplantation; portal vein embolization; hepatectomy; portosystemic shunts.

REFERENCES

  1. Schmidt S, Demartines N, Soler L, Schnyder P, Denys A. Portal vein normal anatomy and variants: Implication for liver surgery and portal vein embolization. Semin Intervent Radiol 2008;25(2):86-91.
  2. Stranding S, Ellis H, Healy JC, Johnson D, Williams A, Collins P. Gray’s Anatomy – Anatomical basis of clinical practice. 40th Edinburgh: Churchill Livingstone; 2005. pp. 2137-45.
  3. Lee VS, Morgan GR, Lin JC, Nazzaro CA, Chang JS, Teperman LW, Krinsky GA. Liver transplant donor candidates: Associations between vascular and biliary anatomic variants. Liver transplantation 2004;10(8):1049-54.
  4. Martins OJ, Assuncao JM, Caroline N, Moura A. Associating liver partition and portal vein ligation for staged hepatectomy: A new approach in Liver resections. ABCD Arq Bras Cir Dig 2012;25(4):290-2.
  5. Munguti J, Odula P, Awori K, Sammy M, Ogeng’o J. Variant anatomy of the Right portal vein in a Black Kenyan population: Anatomy Journal of Africa 2013;2(2):175-80.
  6. Koc Z, Oguzkurt L, Ulusan S. Portal vein variations: Clinical implications and frequencies in routine abdominal multidetector CT. Diagnostic and Interventional Radiology 2007;13:75-80.
  7. Arora J, Kapur V, Kakkar.A, Dixit PC. Ramification of portal vein in right lobe of liver – A Corrosion Cast study. Indmedica – Journal of Anatomical Society of India 2003;52(1):2003-12.
  8. Atasoy C, Ozyurek E. Prevalence and types of main and right portal vein branching variations on MDCT. AJR 2006;187(3):676-81. 

Cite this article: Chaitra BR, Seema Deepak, Dakshayani KR. A STUDY ON TYPE OF BRANCHING PATTERNS OF RIGHT PORTAL VEIN. Int J Anat Res 2018;6(3.3):5637-5642. DOI: 10.16965/ijar.2018.299