Anatomical variations of the hepatic veins: an observational study from a single cadaveric lab in South India

Modern hepatic resections need to consider hepatic vein variations to reduce surgical complications. In this study we determined the variation in the branching pattern of hepatic veins by modified luminal casting technique and evaluated the association of the hepatic vein variations with morphological variations of the liver. The morphological features of thirty formalin-fixed livers were noted. The branching pattern of the hepatic veins was studied by retrograde injection of silicone into the hepatic veins through the inferior vena cava. According to the descriptions given by previous studies, the right, middle, left hepatic veins, and combined middle and left hepatic venous branching patterns were categorized. The data was analyzed statistically. The predominant hepatic vein patterns were De Cecchis type I right hepatic vein (30%), Neumann type I middle hepatic vein (67%), and Reichert type I left hepatic vein (70%). A common trunk for the middle and left hepatic vein was present in 60% and Wind's type II was more common (30%) followed by type I (20%) and type III (10%). While there was no association between the De Cecchis and Wind types, 90% of the conical-shaped livers exhibited type II middle/left hepatic vein pattern of Wind's classification. The present study also observed a rare variation of an accessory inferior left hepatic vein.