Progress in the knowledge of hepatic anatomy is proportionally re

Progress in the knowledge of hepatic anatomy is proportionally related to changes in the evolution of liver transplant techniques. The anatomical segmentation that was defined by Couinaud has guided procedural conduct regarding the procedures for hepatic resection since 1957 (1, 2). The anatomical importance of the intrahepatic biliary ducts came up again in the late 1980s due sellckchem to the advent of liver transplantation from living donors (2, 3). Furthermore, the technique of Split-Liver transplantation allows a single organ from a cadaveric donor to be shared by two living recipients if one is a pediatric recipient while the other is an adult. In both of them the need exists for resection of the parenchyma and performance of multiple anastomoses of intrahepatic bile ducts. Taketomi et al.

reported a 4.1% incidence of postoperative biliary complications in donors (5). An understanding of the anatomy of the biliary tree and its main variations is essential in reduce the rate of biliary leakage and lessen morbidity related to the procedure (6, 7). In this context, increased safety may be provided by following the simple rule that the fewer anastomoses there are, the fewer complications there will be. Thus the determination of the points of confluence of the drainage ducts of each segment is of utmost importance. Despite the emphasized importance in liver transplantation, studying the anatomy of the biliary duct is essential in any surgery involving this organ. Many authors advocate the routine performance of retrograde cholangiopancreatography before any hepatic resection (8).

This statement gains strength when donors are still living, where more severe anomalies may also contraindicate the procedure. Methodology The objective of this study was to evaluate the anatomy of the biliary drainage of the left lobe of the liver through relevant parameters in hepatic resection. These parameters are specified above: Define relationships and distances between the confluence of the main bile ducts involved in the drainage of the left lobe, also noting its relationship with ligamentum venosum of the liver. Evaluate the confluence of the right hepatic duct (RHD) and the left hepatic duct (LHD), and the anomalies thereof. Evaluate the patterns of drainage of the duct of segment I (DSI) and the duct of segment IV (DSIV).

This study evaluated Brefeldin_A cadaveric human livers extracted within a period of up to 24 hours after death. The specimens were obtained from the Department of Forensic Medicine of Porto Alegre – RS. Approval was obtained from the Research and Ethics Committee prior to the beginning of the study. Forty-five organs were used, all of which were removed, during the autopsy while preserving the hiliary vascular pedicle, from the inferior vena cava above the renal veins and below the right atrium.

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