Portal venous branches to the caudate lobe: number and origin

Abstract

Caudate lobectomy is an important procedure commonly used in the treatment of caudate lobe tumors. Hemorrhage prevention and control during this procedure is key in the reduction of intra operative complications but depends on the knowledge of potential bleeders from caudate lobe venous branches. These vessels are known to vary in number and their origin but local statistics are limited. This study therefore aimed at describing the number and origin of portal venous branches to the caudate lobe. Sixty six livers from adult black Kenyans were obtained during autopsy at the Department of Human Anatomy, University of Nairobi – Kenya. The porta hepatis was carefully dissected and the number and origin of the portal venous branches to the caudate lobe observed and recorded. The collected data was analyzed using SPSS version 16. The caudate lobe received 1 portal venous branch in 17 cases (25.8%), 2 branches in 32 cases (48.5%), 3 branches in 13 cases (19.7%) and 4 branches in 4 cases (6%). It received at least 1 branch from the main portal vein in 18 cases (27.3%), from the left portal vein in 56 cases (84.8%) and from the right portal vein in 35 cases (53%). From the results of the current study, a right sided approach for caudate lobectomy would be safer due to less portal venous branches arising from the right portal vein.

Key words: lobectomy, tumors, hemorrhage, metastasis