Morphometric analysis of caudate veins for advanced liver surgery.
BACKGROUND
Accurate knowledge of the surgical anatomy of the caudate lobe is indispensable in the performance of liver surgery. Although previous cast studies have provided much useful overall information about the locations of the caudate veins, little is known about how to establish the exact locations of the caudate and short hepatic veins prior to surgery.


OBJECTIVE
This study was conducted as a practical morphometric analysis of the caudate veins using preoperative enhanced computed tomography (CT) and intraoperative ultrasound (IOUS).


METHODS
From July 2003 to October 2005, 116 donor hepatectomies were performed for adult living donor liver transplantation. The numbers and locations of visible caudate veins were examined pre- and intraoperatively using CT and IOUS.


RESULTS
In the 116 patients, a total of 152 caudate veins were detected, which were classified as being of either typical (n= 135) or non-typical (n= 17) type. One caudate vein was detectable in 83 patients (72%), two in 30 patients (26%) and three in three patients (3%). A total of 67% of caudate veins detected by IOUS and 70% detected by CT were located on the ventral 60 ° of the inferior vena cava (IVC). The remaining veins were scattered on both lateral sides.


CONCLUSIONS
Preoperative CT and IOUS were useful in providing morphometric information of sizable caudate veins. Precise information on these veins is essential for the safe dissection of the caudate lobe from the IVC in advanced liver surgery.
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Nobuyuki
N
Takemura
Kiyoshi
K
Hasegawa
Yasuhiko
Y
Sugawara
Keming
K
Zhang
Taku
T
Aoki
Yoshifumi
Y
Beck
Masatoshi
M
Makuuchi
Norihiro
N
Kokudo
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006498:Hepatectomy; D006503:Hepatic Veins / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007430:Intraoperative Care; D007564:Japan; D008099:Liver / Q000098:blood supply* / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010690:Phlebography / Q000379:methods; D011237:Predictive Value of Tests; D011300:Preoperative Care; D036542:Tomography, Spiral Computed; D014463:Ultrasonography; D054079:Vascular Malformations / Q000175:diagnosis* / Q000000981:diagnostic imaging; D055815:Young Adult