Surgical Anatomy of the Liver and Associated Structures

Abstract

The anatomy of the liver is an excellent example of the importance of this discipline to the surgeon. The internal organisation of the liver was studied intensively by the French anatomist and surgeon Claude Couinaud and his findings were published in 1957 in his book The Liver: anatomical and surgical studies. By analogy with the lung and the heart, the two sides of the liver are best called the right liver and the left liver, and right hepatectomy and left hepatectomy are the appropriate terms for the removal of the right and left sides respectively. This chapter describes the sectors and segments of the liver and their important relationship to surrounding structures. As well, the importance of Glisson’s Capsule and its extensions into the liver surrounding the hepatic ‘trinity’ structures (portal vein, hepatic artery, bile duct), as Glissonian Sheaths, is described. Other important structures such as the abdominal aorta and inferior vena cava and their branches are also described.