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A D V E R T I S E M E N T
A D V E R T I S E M E N T
The portal triad of portal vein, hepatic artery and bile ducts enter the hilum toward the right side, leaving a longer segment of hepatic branches exposed to the left. The portal vein is the most posterior of the three structures, with the bile duct anterior to the right and the hepatic artery anterior to the left. The position of the common bile duct is slightly to the right of the midline overlying the lateral border of the inferior vena cava. Behind the inferior vena cava lies the vertebral column. In order to get a clear view of the bile ducts with a cholangiogram, it is helpful to rotate the patient to the right to move the duct off the vertebrae.
A D V E R T I S E M E N T
Three main hepatic veins drain the liver and lie between major hepatic divisions (see segmental anatomy) in contrast to the hilar conduits which penetrate the center of each hepatic segment. The middle hepatic vein lies between the right and left lobes. The left hepatic vein lies between the medial and lateral segments of the left lobe. The right hepatic vein lies between the anterior and posterior segment of the right lobe. The intersegmental positions of these veins necessitate division of the hepatic parenchyma to one side of the anatomic division when doing hepatic resection in order to reduce blood loss.
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A D V E R T I S E M E N T
The portal vein distribution pattern is representative of the branching of the other hilar structures. The left branch of the portal vein has a longer travel to the left before dividing into medial and lateral segmental branches while the right portal vein divides early into anterior and posterior segmental branches. The portal structures interdigitate with the hepatic vein branches.
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This page was last modified on 3/1/1999.
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