Format

Send to

Choose Destination
Eur J Surg Oncol. 2018 Jul;44(7):1083-1086. doi: 10.1016/j.ejso.2018.03.031. Epub 2018 Apr 11.

The hepatic bridge.

Author information

1
Center for Gastrointestinal Malignancies, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address: Paul.Sugarbaker@medstar.net.

Abstract

BACKGROUND:

The hepatic bridge forms a tunnel of liver parenchyma that may obscure peritoneal metastases associated with the round ligament. Visualization and then resection of nodules associated with this structure is necessary.

MATERIALS AND METHODS:

The incidence of a hepatic bridge and the extent that it covered the round ligament was determined in consecutive patients. Extent of coverage of the round ligament by the hepatic bridge was determined: Class 1 indicates up to one-third of the round ligament obscured, Class 2 up to two-thirds and Class 3 more than two-thirds.

RESULTS:

In 102 patients in whom the round ligament of the liver could be completely visualized, 50 had a hepatic bridge. Class 1 was 22 (44%) of the bridges, Class 2 was 16 (32%) and Class 3 was 12 (24%). A hepatic bridge was more frequently present in 28 of 45 male patients (62%) vs. 22 of 57 female patients (38%).

CONCLUSIONS:

Approximately one-half of our patients having cytoreductive surgery for peritoneal metastases were observed to have a hepatic bridge. Up to 56% of these patients have Class 2 or 3 hepatic bridge and may require division of the hepatic bridge to completely visualize the contents of the tunnel created by this structure.

KEYWORDS:

Biliary obstruction; Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy (HIPEC); Left hepatic duct; Peritoneal tunnel

PMID:
29699839
DOI:
10.1016/j.ejso.2018.03.031
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center