title: Anterior fissure of the right liver--the third door of the liver.
abstract: OBJECTIVE
  Although the anterior segment of the liver has been divided into segments 8 and 5, we have, during surgical or interventional procedures, occasionally encountered patients in whom the right anterior portal vein does not bifurcate into the superior and inferior branches. Thus, the in vivo anatomy of the right liver was reevaluated to clarify the segmental anatomy.
  
  
  METHODS
  We evaluated the hepatic venous and portal ramification patterns, using three-dimensional images reconstructed from computed tomography. In addition, liver volumetry was performed.
  
  
  RESULTS
  All branches arising from the anterior trunk were divided into two groups: the right ventral portal branches (RVP) and the right dorsal portal branches (RDP), and the anterior fissure vein crossed between the RVP and RDP. The ventral and dorsal regions of the anterior segment were approximately equal from a volumetric point of view.
  
  
  CONCLUSIONS
  The anterior segment seems to be divided into the ventral and dorsal segments by the anterior fissure, and we propose a reclassification of the right liver that divides the right liver into three segments. Dissection of the parenchyma along the anterior fissure makes the third door of the liver open, resulting in the exposing of all Glissonian pedicles of the right liver. The introduction of our segmental anatomy and surgical procedure will allow more systematic and limited liver resections.
authors.affiliation: Department of Surgery, Seirei Sakura Hospital, 2-36-2 Ebaradai, Sakura, Chiba 285-8765, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Cho
authors.forename: Shinichi
authors.initials: S
authors.lastname: Okazumi
authors.forename: Harufumi
authors.initials: H
authors.lastname: Makino
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Miura
authors.forename: Kiyohiko
authors.initials: K
authors.lastname: Shuto
authors.forename: Ryouyu
authors.initials: R
authors.lastname: Mochiduki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tohma
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Kudo
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Matsubara
authors.forename: Hisashi
authors.initials: H
authors.lastname: Gunji
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Munemasa
authors.initials: M
authors.lastname: Ryu
authors.forename: Takenori
authors.initials: T
authors.lastname: Ochiai
mesh_terms: D003196:Computer Graphics; D004210:Dissection; D006503:Hepatic Veins / Q000033:anatomy & histology; D006801:Humans; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000033:anatomy & histology* / Q000098:blood supply / Q000000981:diagnostic imaging; D011169:Portal Vein / Q000033:anatomy & histology; D011172:Portography; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography