The arterial vascularization of the liver’s left medial division. Study on corrosion casts.

Abstract

The four divisions of the hepatic parenchyma are vascularized each of them by a branch of second order of the hepatic artery proper (HAP). The medial branch, denominated by the authors the artery of the left medial division (ALMD) (according with the T.A. 1998) vascularizes the left medial division (segment IV). The origin of this artery was analyzed on 115 hepatic corrosion casts. The corrosion casts were realized by the injection of the hepatic vasculo-ductal elements with plastic mass, followed by the corrosion of the hepatic parenchyma with hydrochloric acid. In 89.57% of the cases the HPA forks in the right branch and the left branch. From the left branch originate to the lateral branch and the medial branch (the ALMD), and from the right branch originate the anterior branch and the posterior branch. In 10.43% of the cases, the left branch is continued with the lateral branch, and three branches originate from the right branch, as following: the medial branch (the ALMD), the anterior branch and the posterior branch. In 16.67% of the cases this type of branching of the HAP is often associated with the ramification of the portal hepatic trunk in three branches (left, anterior and posterior). The knowledge of these aspects of variability concerning the origin of the left medial division’s artery is very useful for the planning of hepatic resections in safe conditions. (Supported by CEEX 175/2006).