Anatomy of the portal vein bifurcation: intra- versus extrahepatic location--implications for transjugular intrahepatic portosystemic shunts.
OBJECTIVE
To delineate the relationship of the main portal vein bifurcation to the liver capsule, an anatomic study of the portal vein bifurcation was undertaken in 31 cadavers.


METHODS
The portal bifurcation was characterized as intrahepatic, extrahepatic, or at the liver capsule (junctional). When the bifurcation was extrahepatic, the exposed portions of the right and left portal veins were measured.


RESULTS
The portal bifurcation was intrahepatic in eight cadavers (25.8%), at the liver capsule in eight cadavers (25.8%), and extrahepatic in 15 cadavers (48.4%). The maximum lengths of exposed extrahepatic right and left portal veins were 3.0 cm and 2.5 cm, respectively.


CONCLUSIONS
These findings suggest that for transjugular intrahepatic portosystemic shunt placement, a portal vein puncture site 3 cm from the portal bifurcation will be intrahepatic in most cases.
Schultz
S R
SR
Department of Radiology, University of California, San Francisco 94143-0628.
LaBerge
J M
JM
Gordon
R L
RL
Warren
R S
RS
D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D005260:Female; D006801:Humans; D008099:Liver / Q000033:anatomy & histology*; D008297:Male; D011169:Portal Vein / Q000033:anatomy & histology*; D011170:Portasystemic Shunt, Surgical; D015607:Stents