OP 124. Extrahepatic and Segmental Arterial Supply of The Human Liver and Their Clinical Implications: A Corrosion Cast Study
K. Nemeth, A Szuák, M. Kiss, C. Korom, K. Karlinger, L. Kobori, A. Nemeskeri
Chair(s): Attila Balogh, Thomas Hubert & Krisztián Szigeti
15:40 - 15:50h
at Erszebet Room (A)
Categories: Oral Session, Surgical Anatomy
Session: Oral Session XIV - Surgical Anatomy
Background
The hepatic arterial anatomy is highly variable with normal anatomy present in 50.7%-80.9% of cases. Recognition of abnormalities is of crucial importance, especially during liver transplantation, because an impaired hepatic arterial blood supply may result in ischemic complications. The purpose of our study was to investigate the anatomical variations of the extra- and intrahepatic arterial structures of the liver with particular attention to rare variations and their surgical management.
Material and Methods
Fifty human abdominal organ complexes were used to prepare corrosion casts by applying a multicomponent resin mixture. Digestion was achieved by KOH at 60-65°C for one week. The extrahepatic arterial variations were classified according to Michels and the arterial supply of liver segments was described by the origins of their feeding arteries. 3D CT volumetric reconstructions were made of all specimens.
Result
The unclassified group showed the highest incidence wih 32%, including 11 casts presenting arterial anatomy that have not been reported before. Normal anatomy was found only in 30%. The caudate lobe showed the most variable pattern, we observed 49 different vascular structures in 50 cases; whereas segment VIII. received its segmental artery from the same root in 68% of cases. Virtual hepatectomies were performed to demonstrate the optimal resection planes on the unclassified cases.
Conclusion
Significantly different frequencies of variations were found in our series compared to other publications. We detected new variations including extrahepatic, segmental and combined patterns. Our data may contribute to the reduction of complications during surgical interventions in the upper abdomen.
