Characteristics of Surgical Anatomy of the Left Hepatic Vein: Sonographic Findings

Abstract

Introduction. The development of modern surgery requires the advancement of expertise about individual characteristics of large vessels development. The expansion of surgical treatment options of liver diseases determines the necessity of more detailed information about the anatomy of the portal, biliary and arterial systems, and about the anatomy of the hepatic veins in particular.The aim of research was to study characteristics of the left hepatic vein formation based on ultrasound examination findings.Materials and methods. The study included 39 outpatients, 11 males and 28 females, aged 17-84. Using ultrasound imaging methods, the authors determined linear dimensions, variations and angles of junction of the veins forming the left hepatic vein.Results. The main six variations of the left hepatic vein were determined as follows: variation I was observed in 9 cases (23.1%), variation II - in 7 cases (17.9%), variation III - in 11 cases (28.2%), variation IV - in 6 cases (15.4%), variation V - in 5 cases (12.8%), variation VI - in 1 case (2.6%). The angle of junction of the veins I and III at the site of their entry into the main trunk of the venous system was from 19-21 degrees to 80-85 degrees; the angle of junction of the vein II was from 21 degrees to 61.6 degrees. Deviation of veins in the plane perpendicular to the rest veins ranged from 32 degrees to 81.7 degrees. Additional veins entered at the angles from 22.5 degrees to 45 degrees. When observing, the vein diameter for veins I and II was from 1.3 mm to 4.8 mm, and for vein III - from 1.5 mm to 3.5 mm. There were additional veins determined with an average diameter equal 2.25 mm 0.25 mm. The size of the trunk of the left hepatic vein directly corresponded to a diameter of 2 mm to 7.7 mm.Conclusion. The presented variations are of major importance for modern diagnostic methods, they also expand the understanding of the anatomical variations in the left lobar vein formation, which should be taken into account by surgeons during liver operations.