title: Intrahepatic venous anastomoses with a focus on the middle hepatic vein anastomoses in normal human livers: anatomical study on liver corrosion casts.
abstract: OBJECTIVE
  The aim of this study is to present the anatomical data about intrahepatic venous anastomoses found in normal human livers. The focus is on the middle hepatic vein (MHV) anastomoses, because their existence or non-existence could be of crucial importance in tumour resections as well as in split or living donor liver transplantations.
  
  
  METHODS
  The frequency of livers with intrahepatic venous anastomoses was determined on 164 corrosion casts and the diameter of each anastomosis was measured. Additionally, the type of connection and the position within the liver (liver segment) was determined for each MHV anastomosis.
  
  
  RESULTS
  Intrahepatic venous anastomoses were found in 46 % (75/164), whereas MHV anastomoses were found in 28 % (44/164) of liver casts. Most commonly (39/44), MHV had anastomotic connections with the right hepatic vein (RHV), and also with the inferior RHV, the left hepatic vein and the short subhepatic vein. In more than three quarters of liver casts, MHV-RHV anastomoses were found in liver segment 8; in 45 % of cases, there was more than one anastomosis in this liver segment. The diameter of MHV-RHV anastomoses found in segment 8 was ≥1 mm in 90.6 % of cases.
  
  
  CONCLUSIONS
  As MHV anastomoses were present in more than a quarter of all examined liver casts, we believe that detailed anatomical data presented in this article, together with up to date radiologic technics which enable even 3D reconstruction of venous anastomoses in the liver, could contribute to the clinician's decisions when planning surgical procedures.
authors.affiliation: Faculty of Medicine, Institute of Anatomy, University of Ljubljana, Korytkova 2, 1000, Ljubljana, Slovenia, marjana.hribernik@mf.uni-lj.si.
authors.forename: Marija
authors.initials: M
authors.lastname: Hribernik
authors.forename: Blaž
authors.initials: B
authors.lastname: Trotovšek
mesh_terms: D016319:Corrosion Casting; D006503:Hepatic Veins / Q000033:anatomy & histology*; D006801:Humans; D008099:Liver / Q000098:blood supply*; D016031:Liver Transplantation