The Positional Relationship Between the Inferior Right Hepatic and Posterior Portal Veins.

Area of Science:

• Hepatobiliary surgery
• Anatomical studies
• Surgical landmarks

Background:

• The inferior right hepatic vein (IRHV) is a potential landmark for identifying the portal branch of segment 7 (P7) in anatomical segment 7 (S7) segmentectomy.
• The precise relationship between the IRHV and the posterior portal vein has not been well-defined.

Purpose of the Study:

• To investigate the positional relationship between the inferior right hepatic vein (IRHV) and the posterior portal vein.
• To evaluate the utility of the IRHV and RHV as landmarks for P7 identification in S7 segmentectomy.

Main Methods:

• Retrospective review of 203 patients undergoing preoperative multi-detector CT.
• 3D image processing to analyze the running patterns of the IRHV and RHV relative to portal branches.
• Classification of IRHV courses as S6, S7, or S6/S7.

Main Results:

• Inferior right hepatic veins (IRHVs) were identified in 44.8% of patients.
• The majority of IRHVs (71.4%) were classified as S6/S7, running along the intersegmental plane.
• A significantly higher proportion of patients with IRHVs (92.3%) had either an IRHV or RHV along the P6/P7 intersegmental plane compared to those without IRHVs (24.1%).

Conclusions:

• Most inferior right hepatic veins (IRHVs) course along the S6/S7 intersegmental plane.
• The right hepatic vein (RHV) can serve as an alternative anatomical landmark for identifying P7 when the IRHV is not suitable during S7 segmentectomy.