Venous drainage map of the liver for complex hepatobiliary surgery and liver transplantation.
Inflow and outflow patency of the liver parenchyma is required to maximize the metabolic function of the liver. However, the definition and distribution of hepatic venous drainage regions has yet to be reported. The aim of this study was to define major hepatic venous tributaries and investigate the mean drainage volume of each territory.



Three-dimensional (3D) simulations from the livers of 100 healthy donors were reviewed for living donor liver transplantation to determine the distribution of the significant hepatic venous tributaries and the drainage patterns of each segment.



The left hepatic vein (LHV), middle hepatic vein (MHV), and right hepatic vein (RHV) contributed a mean drainage of 20.7%, 32.7%, and 39.6% of the entire liver, respectively. Accessory hepatic veins accounted for remaining 7.0%. The middle right hepatic vein (MRHV) and inferior right hepatic vein (IRHV) accounted for a mean total drainage of 8.0% and 10.6%, respectively, when they present. In addition, major tributaries of hepatic veins were clearly detected, and their typical distributions were described.



Knowledge of hepatic venous territories is necessary for complex hepatobiliary surgery. This "venous drainage map" may provide useful information for complex liver surgery and transplantation.
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Japan.
Keigo
K
Tani
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Japan; Hepatobiliary-Pancreatic Surgery Division, Department of Digestive Surgery, Toranomon Hospital, Japan. Electronic address: shindou-tky@umin.ac.jp.
Junichi
J
Shindoh
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Japan.
Nobuhisa
N
Akamatsu
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Japan.
Junichi
J
Arita
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Japan.
Junichi
J
Kaneko
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Japan.
Yoshihiro
Y
Sakamoto
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Japan.
Kiyoshi
K
Hasegawa
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Japan. Electronic address: KOKUDO-2SU@h.u-tokyo.ac.jp.
Norihiro
N
Kokudo
D000328:Adult; D001662:Biliary Tract Surgical Procedures; D000072226:Computed Tomography Angiography; D005260:Female; D064368:Healthy Volunteers; D006498:Hepatectomy; D006503:Hepatic Veins / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000098:blood supply* / Q000601:surgery; D008102:Liver Circulation; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D066230:Patient-Specific Modeling; D010690:Phlebography / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted; D055815:Young Adult
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