Display Settings:

Format

Send to:

Choose Destination
We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
    Anat Rec (Hoboken). 2008 Jun;291(6):636-42. doi: 10.1002/ar.20658.

    Portal venous territories within the human liver: an anatomical reappraisal.

    Source

    Clinical Anatomy Research Group, Departments of Cellular Physiology, Metabolism and Surgery, University Medical Center and Hospital, Geneva, Switzerland. jean.fasel@medecine.unige.ch

    Abstract

    Subdivision of the human liver into eight portal venous segments (according to Couinaud) is largely established in the anatomical and clinical community. However, this concept is challenged by an increasing number of surgical and radiological reports. We reexamined the intrahepatic portal venous architecture to understand the inconsistencies published. For this purpose, we studied the livers of 20 deceased who had donated their body to the Anatomy Department. The organs were investigated by portal venous injection, subsequent liver corrosion, and analysis of the branching pattern. After a usual bifurcation of the portal vein (order 0 vessel) into a right and left branch (first order vessels), the number of second order branches observed was between 9 and 44, with an average of 20. This seemingly trivial matter of fact suggests that the human liver does not consist of the eight segments presumed, but of many more. Supposedly contradictory observations turn out to be explainable by differing combinations of this large number of territories, and not simply by anatomical variability. For practical surgical purposes, we conclude that the useful eight-segment scheme needs conceptual reappraisal when a more realistic approach to the individual hepatic territoriality in the patients under consideration is demanded. We submit a "1-2-20-concept" as a possible key.

    PMID:
    18484609
    [PubMed - indexed for MEDLINE]
    Free full text

      Supplemental Content

      Icon for John Wiley & Sons, Inc.

      Save items

      Recent activity

      Your browsing activity is empty.

      Activity recording is turned off.

      Turn recording back on

      See more...
      Write to the Help Desk