Applied 3-D anatomy of liver bile ducts in injection-corrosion casts

• Main Authors: Jurković Dragica M., Korneti-Pekevska Kostandina L
• Format: Article
• Language: English
• Published: Association of medical doctors Sanamed Novi Pazar 2013-03-01
• Series: Sanamed
• Subjects: liver; intrahepatic bile duct; portal vein; injection-corrosion method; segmentation
• Online Access: http://sanamed.rs/sanamed_pdf/sanamed_8_1/APPLIED_3-D_ANATOMY.pdf

On the 20 post-autopsy adult isolated liver specimens of patients of both sexes (17 male and 3 female) aged 29-88, the injection-corrosion method was used. Colored acrylate was injected into the biliary system, and uncolored acrylate into the portal vein. A total of 17 acrylate casts were of proper quality. Within the 9 portal segments, both the anatomical determination and quantity and the mode of confluence of intrahepatic bile ducts were established. Different modes of biliary tract confluence up to the sectors and hepatics were found. Besides the most frequent findings of convention­ally confluence bile ducts, there were aberrant modalities of biliary drainage in eight cases. Among them 5 cases had confluence of posterior and anterior sector ducts in the left hepatic duct and 1 case had confluence at first of anterior and then posterior sector ducts in the left hepatic duct. Also, extrahilar connection of the right posterior with left lateral into common hepatic duct, where the latter entered the medial and anterior sectors ducts in 1 case was found. There was a subsequent confluence of ducts from the 8th and 5th segments in 1 case, and from the lateral and medial sectors with or without caudate lobe in 3 cases. A common (4) or separate (2) confluence of left and right portions ducts in the left drainage system were in 6 cases, whereas in both, the left and right drainage system in 7 cases was found. Rare, there was an aberrant single channel from the right portion in 1 case, as well as the presence and biliary drainage only of the left portion of 1st segment was found. Segment 9 bile ducts drained all three subsegments (b, c and d) in 10 cases, and only two (c and d) in 3 cases, as well as only two (c and b) of present three subsegments in 3 cases. Also, there was even one case with present 9d subsegment and without 9th segment duct. Those modalities are of interest in an applying and accurate interpretation and performance of diagnostic and interventional procedures, as well as in segmental, sectoral or hemihepatic resection in liver surgery.