Ramification pattern and morphometry of major hepatic veins of liver by silicone cast method: Its clinical relevance to liver surgeries

Abstract

Background: Liver being the largest organ in the body receives blood supply from hepatic artery (25%) and portal vein (75%) and drained by three major hepatic veins opening into inferior vena cava. The dimensions of hepatic veins are quite essential during portosystemic shunting procedure and radiological interventions. The presence of variants of major hepatic veins is of prime importance to evaluate donor and recipient in living donor liver transplantation. Objectives: The objectives of the study were (1) to evaluate the ramification pattern and morphometry of major hepatic veins of liver by cast method and (2) to study the clinical implications of the hepatic vein variations. Materials and Methods: Forty liver specimens (22 males and 18 females) aged between 30 and 60 years were obtained from the Department of Forensic Medicine of JSS Medical College and Mysore Medical College. The silicone gel was injected into vena cava and pushed thoroughly into the ostia of hepatic veins. The drainage patterns of hepatic veins were noted and measurement of hepatic veins was done using thread and measuring scale. Results: The present study ramification pattern of middle and left hepatic veins showed Type 1 pattern in 24 specimens (58%), Type 2 in 12 specimens (40%), and Type 3 in 5 specimens (12%). There was a significant difference with P < 0.05 in all the parameters among males and females except the length and diameter of common trunk. Conclusion: Thorough knowledge of hepatic vein variants and its morphometry is essential during imaging procedures, anatomic resection of hepatic veins in hepatocellular carcinoma, liver transplantation, and other liver surgeries.