Measurements between the hepatic veins and portal venous system, in human cirrhotic liver: a cast study
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To measure the distance between the right and middle hepatic veins and portal vein branches, in human cirrhotic liver casts. Was this measure actually smaller in the cirrhotic liver than in normal one?
Materials and methods
This study was authorized by an area Research Ethics Committee, and each study subject or legal representative granted signed informed consent. Acrylic corrosion casts of 21 resected cirrhotic livers were generated. Diameters of hepatic veins and portal branches and pertinent intervening distances were measured. To assess differences in estimated average (relative to reference values), Student’s t test for one sample was applied.
Mean distances from right hepatic vein to the right portal branch and to portal vein bifurcation were 33 ± 6.4 and 36 ± 7.4 mm, respectively, both significantly less than published reference values in healthy human livers (p < 0.0001 and p < 0.0002, respectively). Mean distances from middle hepatic vein to right and left branches of portal vein were 36 ± 6.8 and 26 ± 8.8 mm, respectively.
Distances separating right hepatic vein and portal vein (right branch and bifurcation) are diminished in cirrhotic livers compared to healthy ones. Given its caliber and proximity to portal branches, the middle hepatic vein remains as a reasonable alternative for TIPS procedures.
KeywordsAnatomy Cirrhosis Hepatic veins Portal system Corrosion casting
We are grateful to all patients and their family members who collaborated in this study; to Dr. Bernardo Sabat by facilitating access to organs studied; to Dr. Norma Jucá for the histologic studies; to the mathematician Ulysses Montarroyos for the assistance in statistics; to staff of the Jayme da Fonte Hospital for the access to the surgical rooms; to the medicine student Elton-Kim Santos for his help in English-language translation and to Caio Lima for the drawing of liver.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest concerning this article.
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