Anatomy of the ligamentum venosum arantii and its contribution to the left hepatic vein and common trunk control. A study on cadaveric livers.
BACKGROUND
The control of the left hepatic vein (LHV) and the common trunk of the middle hepatic vein (MHV) and LHV (CT) is considered difficult during liver resection and could be improved by detailed knowledge on the ligamentum venosum Arantii (LV).


OBJECTIVE
The aim of this study was to describe the LV and its connections to the LHV and the CT and to present surgical relevance of the obtained data.


METHODS
During autopsy of 50 cadavers of both sexes, the LV was exposed, measured and then dissected, simulating a surgical maneuver to facilitate the approach to the LHV and CT. The extrahepatic parts of the LHV, MHV and CT were measured.


RESULTS
The LV was 52-70 mm long and 5-8 mm thick. It had a fibrotic structure and was not patent in 96% of the cases. The extrahepatic part of the LHV measured 3-19 mm, that of the MHV 3-18 mm and that of the CT 4-15 mm.


CONCLUSIONS
LV dissection facilitated extraparenchymatous clamping of the hepatic veins: the extrahepatic parts of the LHV and CT measured > 3 mm in 86 and 84% of the cases, respectively.
Dahmane
Raja
R
Institute of Anatomy, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. raja.dahmane@guest.arnes.si
Morjane
Abdelwaheb
A
Ravnik
Dean
D
Hribernik
Marija
M
D000328:Adult; D000368:Aged; D000886:Anthropometry; D003964:Diaphragm / Q000098:blood supply; D004210:Dissection; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006498:Hepatectomy / Q000295:instrumentation / Q000379:methods; D006503:Hepatic Veins / Q000033:anatomy & histology* / Q000502:physiology / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008022:Ligaments / Q000033:anatomy & histology* / Q000196:embryology / Q000601:surgery; D008099:Liver / Q000098:blood supply* / Q000502:physiology / Q000601:surgery; D008102:Liver Circulation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000502:physiology* / Q000601:surgery; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D013525:Surgical Instruments; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000379:methods; D014682:Vena Cava, Inferior / Q000502:physiology / Q000601:surgery; D055815:Young Adult