Anatomical study of the morphometry of portal caudate veins

Abstract

The caudate lobe is a relatively unknown part of the liver due to its location and many variations. The caudate lobe is a separate entity that is located behind the trunk of the portal vein.It constitutes the hepatic dorsal area that comprises of only segment I. Thus, this lobe can be vascularized by caudate veins (CV) born either from the right branch of the portal vein (PV),from the left branch or from both. Therefore, the work allows us to study the morphometry of caudate veins. Based on the exploitation of vascular mussels of the inferior vena cava and the portal vein after injection-corrosion of the liver, the study conducted from April 2018 to March 2019 involved 41 livers of which 30 were exploited for caudate veins. These were from fresh adult subjects, both sexes free of any hepatobilio-pancreatic pathology or trauma. The injection-corrosion parts of his vascular mussels included the hepatobasement junction and the hepatic pedicle. The PV and its right and left branches provided accessory caudate branches for the caudate lobe at the level of the hepatic hilum. Thus, for all livers, we found 102 branches cauded by accessories. The accessory caudate veins were born either from the left branch of the PV in 28 livers out of 30 (93.37% ), by 1 to 4 vessels with an average distance between its branches and the portal bifurcation being 17 mm with extremes ranging from 7 to 39 mm; either from the right branch of the PV in 23 livers out of 30(76.6%), by 1 to 3 vessels with an average distance of 12.9 mm between its branches and the portal bifurcation, with extremes ranging from 9 to 18 mm. The stem of the portal vein gave branches to the caudate lobe in 11 livers on 30(36.6%),by 1 to 2 vessels whose diameter varied from 1 mm to 3 mm. We studied on 30 liver samples the anatomical variations related to CV. This is a contribution to the fundamental foundations of liver removal surgery because too little work (and often radiological) exists in Africa on the subject. However, this lack of comparative anthropometric data confirms the diversity of anatomical variations in caudate veins. On the therapeutic level these anatomical data contribute to the peri-operative safety of liver surgery.