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Intrahepatic Vascular Anatomy in Rats and Mice--Variations and Surgical Implications.

Sänger C, Schenk A, Schwen LO, Wang L, Gremse F, Zafarnia S, Kiessling F, Xie C, Wei W, Richter B, Dirsch O, Dahmen U - PLoS ONE (2015)

Bottom Line: Surgically relevant variations were primarily observed in portal venous supply.We showed that lobar borders of the liver do not always match vascular territorial borders.These findings are of importance for the design of new surgical procedures and for understanding eventual complications following hepatic surgery.

View Article: PubMed Central - PubMed

Affiliation: Universitätsklinikum Jena, Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Experimentelle Transplantationschirurgie, Jena, Germany.

ABSTRACT

Introduction: The intra-hepatic vascular anatomy in rodents, its variations and corresponding supplying and draining territories in respect to the lobar structure of the liver have not been described. We performed a detailed anatomical imaging study in rats and mice to allow for further refinement of experimental surgical approaches.

Methods: LEWIS-Rats and C57Bl/6N-Mice were subjected to ex-vivo imaging using μCT. The image data were used for semi-automated segmentation to extract the hepatic vascular tree as prerequisite for 3D visualization. The underlying vascular anatomy was reconstructed, analysed and used for determining hepatic vascular territories.

Results: The four major liver lobes have their own lobar portal supply and hepatic drainage territories. In contrast, the paracaval liver is supplied by various small branches from right and caudate portal veins and drains directly into the vena cava. Variations in hepatic vascular anatomy were observed in terms of branching pattern and distance of branches to each other. The portal vein anatomy is more variable than the hepatic vein anatomy. Surgically relevant variations were primarily observed in portal venous supply.

Conclusions: For the first time the key variations of intrahepatic vascular anatomy in mice and rats and their surgical implications were described. We showed that lobar borders of the liver do not always match vascular territorial borders. These findings are of importance for the design of new surgical procedures and for understanding eventual complications following hepatic surgery.

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Portal vein variations of the right lobe and surgical implications in rats. 3D visualization.A) Visualization of portal vein vascular tree. Single supply of RSL and RIL was observed in 4 of 14 cases. B) Portal venous territories. A ligation of right superior PV or resection of RSL without compromising of portal venous supply of RIL is possible. C) Portal venous territories. The craniodorsal part of the RIL is supplied by right superior PV in 10 of 14 cases. D) Portal venous territories. Ligation of right superior PV or resection of RSL leads to lack of portal supply in half of the right inferior lobe. Red line is resection line or ligation of PV. Encircled is the right lobe. ICL-inferior caudate lobe, LML-left median lobe, LLL-left lateral lobe, PV-portal vein, RIL-right inferior lobe, RML-right median lobe, RSL-right superior lobe, SCL-superior caudate lobe.
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pone.0141798.g002: Portal vein variations of the right lobe and surgical implications in rats. 3D visualization.A) Visualization of portal vein vascular tree. Single supply of RSL and RIL was observed in 4 of 14 cases. B) Portal venous territories. A ligation of right superior PV or resection of RSL without compromising of portal venous supply of RIL is possible. C) Portal venous territories. The craniodorsal part of the RIL is supplied by right superior PV in 10 of 14 cases. D) Portal venous territories. Ligation of right superior PV or resection of RSL leads to lack of portal supply in half of the right inferior lobe. Red line is resection line or ligation of PV. Encircled is the right lobe. ICL-inferior caudate lobe, LML-left median lobe, LLL-left lateral lobe, PV-portal vein, RIL-right inferior lobe, RML-right median lobe, RSL-right superior lobe, SCL-superior caudate lobe.

Mentions: The right inferior lobe was supplied either by a single right inferior portal vein branch (6 of 18 cases, see Fig 2A and 2B) or a group of branches (12 of 18 cases). In these 12 of 18 cases the craniodorsal part of the right inferior lobe was additionally supplied by one (6 of 18 cases) or two (6 of 18 cases) branches of third order from the right superior lobe (Fig 2C). The 12 of 18 cases are also of surgical relevance. Resecting the right upper lobe will cause a lack of portal/arterial supply in half of the right inferior lobe, when ligating the right superior portal vein with or without the right hepatic artery prior to resecting the lobe (Fig 2D). This would lead to a necrosis in this area


Intrahepatic Vascular Anatomy in Rats and Mice--Variations and Surgical Implications.

Sänger C, Schenk A, Schwen LO, Wang L, Gremse F, Zafarnia S, Kiessling F, Xie C, Wei W, Richter B, Dirsch O, Dahmen U - PLoS ONE (2015)

Portal vein variations of the right lobe and surgical implications in rats. 3D visualization.A) Visualization of portal vein vascular tree. Single supply of RSL and RIL was observed in 4 of 14 cases. B) Portal venous territories. A ligation of right superior PV or resection of RSL without compromising of portal venous supply of RIL is possible. C) Portal venous territories. The craniodorsal part of the RIL is supplied by right superior PV in 10 of 14 cases. D) Portal venous territories. Ligation of right superior PV or resection of RSL leads to lack of portal supply in half of the right inferior lobe. Red line is resection line or ligation of PV. Encircled is the right lobe. ICL-inferior caudate lobe, LML-left median lobe, LLL-left lateral lobe, PV-portal vein, RIL-right inferior lobe, RML-right median lobe, RSL-right superior lobe, SCL-superior caudate lobe.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664386&req=5

pone.0141798.g002: Portal vein variations of the right lobe and surgical implications in rats. 3D visualization.A) Visualization of portal vein vascular tree. Single supply of RSL and RIL was observed in 4 of 14 cases. B) Portal venous territories. A ligation of right superior PV or resection of RSL without compromising of portal venous supply of RIL is possible. C) Portal venous territories. The craniodorsal part of the RIL is supplied by right superior PV in 10 of 14 cases. D) Portal venous territories. Ligation of right superior PV or resection of RSL leads to lack of portal supply in half of the right inferior lobe. Red line is resection line or ligation of PV. Encircled is the right lobe. ICL-inferior caudate lobe, LML-left median lobe, LLL-left lateral lobe, PV-portal vein, RIL-right inferior lobe, RML-right median lobe, RSL-right superior lobe, SCL-superior caudate lobe.
Mentions: The right inferior lobe was supplied either by a single right inferior portal vein branch (6 of 18 cases, see Fig 2A and 2B) or a group of branches (12 of 18 cases). In these 12 of 18 cases the craniodorsal part of the right inferior lobe was additionally supplied by one (6 of 18 cases) or two (6 of 18 cases) branches of third order from the right superior lobe (Fig 2C). The 12 of 18 cases are also of surgical relevance. Resecting the right upper lobe will cause a lack of portal/arterial supply in half of the right inferior lobe, when ligating the right superior portal vein with or without the right hepatic artery prior to resecting the lobe (Fig 2D). This would lead to a necrosis in this area

Bottom Line: Surgically relevant variations were primarily observed in portal venous supply.We showed that lobar borders of the liver do not always match vascular territorial borders.These findings are of importance for the design of new surgical procedures and for understanding eventual complications following hepatic surgery.

View Article: PubMed Central - PubMed

Affiliation: Universitätsklinikum Jena, Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Experimentelle Transplantationschirurgie, Jena, Germany.

ABSTRACT

Introduction: The intra-hepatic vascular anatomy in rodents, its variations and corresponding supplying and draining territories in respect to the lobar structure of the liver have not been described. We performed a detailed anatomical imaging study in rats and mice to allow for further refinement of experimental surgical approaches.

Methods: LEWIS-Rats and C57Bl/6N-Mice were subjected to ex-vivo imaging using μCT. The image data were used for semi-automated segmentation to extract the hepatic vascular tree as prerequisite for 3D visualization. The underlying vascular anatomy was reconstructed, analysed and used for determining hepatic vascular territories.

Results: The four major liver lobes have their own lobar portal supply and hepatic drainage territories. In contrast, the paracaval liver is supplied by various small branches from right and caudate portal veins and drains directly into the vena cava. Variations in hepatic vascular anatomy were observed in terms of branching pattern and distance of branches to each other. The portal vein anatomy is more variable than the hepatic vein anatomy. Surgically relevant variations were primarily observed in portal venous supply.

Conclusions: For the first time the key variations of intrahepatic vascular anatomy in mice and rats and their surgical implications were described. We showed that lobar borders of the liver do not always match vascular territorial borders. These findings are of importance for the design of new surgical procedures and for understanding eventual complications following hepatic surgery.

Show MeSH