Identification of the anterior sectoral trunk with particular reference to the hepatic hilar plate and its clinical importance.
BACKGROUND
At the hilum of the liver, there is a structure called the hilar plate, which is of great surgical importance because all variations in the bile ducts and blood vessels occur within this region. The Rex-Cantlie line does not always pass the point of portal bifurcation. Classifying portal vein (PV) variations based on the shape and origin of anterior sectoral trunk (AST) within the hepatic plate system will be of higher anatomical and surgical value than the conventional method based on PV ramification.


METHODS
We investigated PV variations in the hilar plate in terms of combinations of 4 hepatic sectoral trunks rather than successive ramification of the PV. The combination patterns of each sectoral trunk were analyzed using data from adult cadaver liver dissection (n = 64) and multi-detector computed tomography (n = 216) of human livers.


RESULTS
The AST root position on the hilar plate varies, in contrast to the other sectoral trunks, which are relatively consistent in their root position. Three types of PV variations were identified based on the AST root position. In addition, 4 similar but different shapes (I, Y, V, and U) of AST were identified.


CONCLUSIONS
Not only the root position in the hepatic hilar plate but also the shape of AST can be considered as the major determinants of PV variations.
Yu
Hee Chul
HC
Department of Surgery and Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea.
Jin
Zhe Wu
ZW
Jin
Guang Yu
GY
You
Heecheon
H
Moon
Jang Il
JI
Chung
Jin Wook
JW
Hwang
Shin
S
Cho
Baik Hwan
BH
D000328:Adult; D000368:Aged; D006801:Humans; D008099:Liver / Q000033:anatomy & histology* / Q000098:blood supply / Q000000981:diagnostic imaging; D008875:Middle Aged; D011169:Portal Vein / Q000033:anatomy & histology*; D011859:Radiography