Study on the portal ramification pattern of the right anterior sector of the liver and a unique medial branch (PV8c) of the right anterior portal vein

Abstract Aim The concept of Couinaud segmentation is widely used in clinical practice. However, there were no definite anatomical landmarks between segments V and VIII. Therefore, segmentation of the right anterior sector is still controversial. We aimed to investigate the portal segmentation of the...

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Main Authors: Norihiro Ishii, Norifumi Harimoto, Kimitaka Kogure, Kenichiro Araki, Kei Hagiwara, Mariko Tsukagoshi, Takamichi Igarashi, Akira Watanabe, Norio Kubo, Ken Shirabe
Format: Article
Language:English
Published: Wiley 2022-09-01
Series:Annals of Gastroenterological Surgery
Subjects:
Online Access:https://doi.org/10.1002/ags3.12561
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author Norihiro Ishii
Norifumi Harimoto
Kimitaka Kogure
Kenichiro Araki
Kei Hagiwara
Mariko Tsukagoshi
Takamichi Igarashi
Akira Watanabe
Norio Kubo
Ken Shirabe
author_facet Norihiro Ishii
Norifumi Harimoto
Kimitaka Kogure
Kenichiro Araki
Kei Hagiwara
Mariko Tsukagoshi
Takamichi Igarashi
Akira Watanabe
Norio Kubo
Ken Shirabe
author_sort Norihiro Ishii
collection DOAJ
description Abstract Aim The concept of Couinaud segmentation is widely used in clinical practice. However, there were no definite anatomical landmarks between segments V and VIII. Therefore, segmentation of the right anterior sector is still controversial. We aimed to investigate the portal segmentation of the right anterior sector using 3D image analysis, and to reveal the existence of the medial branch (PV8c), a unique, characteristic branch of the right anterior portal vein. Methods The ramification form and pattern of the tertiary portal branch of the right anterior portal vein were retrospectively analyzed, and the frequency of PV8c was evaluated in 261 patients between January 2016 and June 2020. Results The ramification pattern of tertiary portal branches of the right anterior portal vein was classified into four types: craniocaudal, 28.0% of patients; ventrodorsal, 21.8%; trifurcation, 39.5%; and quadfurcation, 5.7%, and each type was further subdivided into six patterns by focusing especially on the caudal branches. The ramification pattern in the remaining 5.0% of the livers did not belong to the above‐mentioned four types. The PV8c branch was identified in 140 of 261 livers (53.6%); the mean proportion of the feeding area of PV8c in the whole liver volume was 3.4%. Conclusion Since the ramification pattern of tertiary portal branches of the right anterior portal vein does not necessarily show a single pattern, it is important to confirm the portal vein branching in each case during hepatectomy. This is the first study of the details of PV8c by 3D computed tomography.
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spelling doaj.art-1aa475fdc931431e88cb50b0c4bb059c2022-12-22T01:44:07ZengWileyAnnals of Gastroenterological Surgery2475-03282022-09-016567968710.1002/ags3.12561Study on the portal ramification pattern of the right anterior sector of the liver and a unique medial branch (PV8c) of the right anterior portal veinNorihiro Ishii0Norifumi Harimoto1Kimitaka Kogure2Kenichiro Araki3Kei Hagiwara4Mariko Tsukagoshi5Takamichi Igarashi6Akira Watanabe7Norio Kubo8Ken Shirabe9Department of General Surgical Science Division of Hepatobiliary and Pancreatic Surgery Graduate School of Medicine Gunma University Gunma JapanDepartment of General Surgical Science Division of Hepatobiliary and Pancreatic Surgery Graduate School of Medicine Gunma University Gunma JapanDepartment of General Surgical Science Graduate School of Medicine Gunma University Gunma JapanDepartment of General Surgical Science Division of Hepatobiliary and Pancreatic Surgery Graduate School of Medicine Gunma University Gunma JapanDepartment of General Surgical Science Division of Hepatobiliary and Pancreatic Surgery Graduate School of Medicine Gunma University Gunma JapanDepartment of General Surgical Science Division of Hepatobiliary and Pancreatic Surgery Graduate School of Medicine Gunma University Gunma JapanDepartment of General Surgical Science Division of Hepatobiliary and Pancreatic Surgery Graduate School of Medicine Gunma University Gunma JapanDepartment of General Surgical Science Division of Hepatobiliary and Pancreatic Surgery Graduate School of Medicine Gunma University Gunma JapanDepartment of General Surgical Science Division of Hepatobiliary and Pancreatic Surgery Graduate School of Medicine Gunma University Gunma JapanDepartment of General Surgical Science Division of Hepatobiliary and Pancreatic Surgery Graduate School of Medicine Gunma University Gunma JapanAbstract Aim The concept of Couinaud segmentation is widely used in clinical practice. However, there were no definite anatomical landmarks between segments V and VIII. Therefore, segmentation of the right anterior sector is still controversial. We aimed to investigate the portal segmentation of the right anterior sector using 3D image analysis, and to reveal the existence of the medial branch (PV8c), a unique, characteristic branch of the right anterior portal vein. Methods The ramification form and pattern of the tertiary portal branch of the right anterior portal vein were retrospectively analyzed, and the frequency of PV8c was evaluated in 261 patients between January 2016 and June 2020. Results The ramification pattern of tertiary portal branches of the right anterior portal vein was classified into four types: craniocaudal, 28.0% of patients; ventrodorsal, 21.8%; trifurcation, 39.5%; and quadfurcation, 5.7%, and each type was further subdivided into six patterns by focusing especially on the caudal branches. The ramification pattern in the remaining 5.0% of the livers did not belong to the above‐mentioned four types. The PV8c branch was identified in 140 of 261 livers (53.6%); the mean proportion of the feeding area of PV8c in the whole liver volume was 3.4%. Conclusion Since the ramification pattern of tertiary portal branches of the right anterior portal vein does not necessarily show a single pattern, it is important to confirm the portal vein branching in each case during hepatectomy. This is the first study of the details of PV8c by 3D computed tomography.https://doi.org/10.1002/ags3.12561anterior sectorcaudate lobeCouinaud segmentationportal ramificationthree‐dimensional imaging
spellingShingle Norihiro Ishii
Norifumi Harimoto
Kimitaka Kogure
Kenichiro Araki
Kei Hagiwara
Mariko Tsukagoshi
Takamichi Igarashi
Akira Watanabe
Norio Kubo
Ken Shirabe
Study on the portal ramification pattern of the right anterior sector of the liver and a unique medial branch (PV8c) of the right anterior portal vein
Annals of Gastroenterological Surgery
anterior sector
caudate lobe
Couinaud segmentation
portal ramification
three‐dimensional imaging
title Study on the portal ramification pattern of the right anterior sector of the liver and a unique medial branch (PV8c) of the right anterior portal vein
title_full Study on the portal ramification pattern of the right anterior sector of the liver and a unique medial branch (PV8c) of the right anterior portal vein
title_fullStr Study on the portal ramification pattern of the right anterior sector of the liver and a unique medial branch (PV8c) of the right anterior portal vein
title_full_unstemmed Study on the portal ramification pattern of the right anterior sector of the liver and a unique medial branch (PV8c) of the right anterior portal vein
title_short Study on the portal ramification pattern of the right anterior sector of the liver and a unique medial branch (PV8c) of the right anterior portal vein
title_sort study on the portal ramification pattern of the right anterior sector of the liver and a unique medial branch pv8c of the right anterior portal vein
topic anterior sector
caudate lobe
Couinaud segmentation
portal ramification
three‐dimensional imaging
url https://doi.org/10.1002/ags3.12561
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