The Liver and Portal System

Abstract

Understanding of the anatomy and physiology of the liver and techniques for safe anatomic and nonanatomic liver resections has evolved over the past several decades. The liver is composed of a complex arterial and portal venous inflow, which has several important variants that are crucial for the surgeon to understand when planning hepatic resections, both anatomic and nonanatomic. In addition, intra- and extrahepatic biliary configurations may be encountered, and variants must be recognized to prevent complications during common surgical procedures, such as cholecystectomy and liver resection. The liver is responsible for numerous metabolic, homeostatic, and immunologic processes throughout the body. It is crucial for the practicing physician and surgeon to have a fundamental understanding of hepatic anatomy and physiology when treating patients with derangements in liver structure and function. Key words: bile duct, bilirubin, bilirubin metabolism, hepatic artery, hepatic blood flow, hepatic parenchyma microstructure, liver anatomy, portal hypertension, portal vein