Anatomy of the portal vein bifurcation: implication for transjugular intrahepatic portal systemic shunts.
OBJECTIVE
The relationship of the portal vein bifurcation to the liver capsule in Asians, which is an important landmark for transjugular intrahepatic portosystemic shunt, has not previously been described.


METHODS
The anatomy of the portal vein bifurcation was studied in 70 adult Chinese cadavers; it was characterized as intrahepatic or extrahepatic. The length of the exposed portion of the right and left portal veins was measured when the bifurcation was extrahepatic.


RESULTS
The portal vein bifurcation was intrahepatic in 37 cadavers (53%) and extrahepatic in 33 cadavers (47%). The mean length of the right and left extrahepatic portal veins was 0.96 cm and 0.85 cm respectively. Both were less than or equal to 2 cm in 94% of the cadavers with extrahepatic bifurcation. There was no correlation between the presence of cirrhosis and the location of the portal vein bifurcation (p = 1.0). There was no statistically significant difference in liver mass in cadavers with either extrahepatic or intrahepatic bifurcation (p = 0.40).


CONCLUSIONS
These findings suggest that for transjugular intrahepatic portosystemic shunt placement, a portal vein puncture 2 cm from the bifurcation will be safe in most cases.
Kwok
Philip Chong-hei
PC
Department of Radiology and Imaging, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong. pchkwok@ha.org.hk
Ng
Wai Fu
WF
Lam
Christine Suk-yee
CS
Tsui
Polly Po
PP
Faruqi
Asma
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia; D001344:Autopsy; D005260:Female; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000033:anatomy & histology* / Q000473:pathology; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D013223:Statistics as Topic