Hepatic ligaments

Central peritoneotomy with resection of midline scars of previous operations and ventral hepatic ligaments... 

Fig. 7.7 Congested lymphatic vessels in the area of the medial part of the right lobe of liver (insertion of the left falciform ligament can be clearly identified) with partial vessel wall segmentation. Here in chronic toxic hepatitis...

Imaging techniques (with the exception of ERC, e. g. in PSC) are generally of no diagnostic value in chronic hepatitis prior to the development of cirrhosis. Sonography is regarded as a basic, routine examination and is always indicated in cholestatic diseases or suspected cirrhosis. (9) There is often evidence of abdominal lymphadenopathy (especially of the hepatoduodenal ligament), which points to a more severe histological... 

Muller, R, Renou, C., Harafa, A., Jouve, E., Kaplanski, G., Ville, E., Bertrand, J.J., Masson, C., Benderitter, T., Halfon, R Lymph node enlargement within the hepatoduodenal ligament in patients with chronic hepatitis C reflects the immunological cellular response of the host. J. Hepatol. 2003 39 807-813... 

Fig. 37.16 Large metastasis in the right hepatic lobe with distinct cancer umbilicus subsequent to breast cancer (serosa, peritoneum and ligaments without pathological findings)...

Accessory portal veins are small veins at the surface of the hepatic serosa and in the surrounding peritoneal folds which normally originate in the diaphragm and the stomach. They can either open into the portal vein or enter the liver parenchyma independently. Anomalous accessory portal veins may sometimes originate in the area of the portal veins around the gall bladder, the porta hepatis, the omentum, the interior surface of the abdominal wall or the hepatorenal ligament, etc. 

In the setting of cadaveric liver transplantation it is more important to identify vascular anomalies of the celiac axis than hepatic artery variations. Indeed, celiac axis anomalies, such as atheromatous celiac-trunk stenosis or diaphragmatic arcuate ligament, could necessitate celiac axis revasculariza-... 

The classic common hepatic artery (CHA) lies in the hepatoduodenal ligament to the left of the common bile duct and anterior to the portal vein (Lee et al. 2002). In general, the CHA divides into a right and left hepatic artery (Fig. 2.5.4). However, the anatomy of the arterial supply of the liver often shows congenital variations. Common variants of the hepatic artery are having the origin of the left hepatic artery... 

Fig. 4.2. Inferior aspect of the liver the round ligament continues into the umhilical portion of the left portal vein (at an anatomical landmark called Rex s recessus). The hepatic pedicle spreads out, near the liver, as a virtual space called the porta hepatis or hepatic hilum (defined by the bifurcation of the portal vein) and divides into a shorter right pedicle and a longer left pedicle. The left pedicle separates a quadrate lobe anteriorly and a round caudate lobe posteriorly and arches up as an umbilical portion to join the round ligament. Arantius ligament runs from the angle between the transverse portion and the umbilical portion of the left portal vein to the confluence of the left and middle hepatic veins. The right hepatic pedicle is in contact with the gallbladder that defines the right border of the quadrate lobe. Posteriorly the right hepatic pedicle is separated from the vena cava by a rim of liver tissue that corresponds to the right portion of the caudate lobe...

In the left liver the main landmark is the left portal vein, and the second landmark is the left hepatic vein. The left portal vein describes a smooth arch from the main bifurcation to the lunbihcal ligament. All liver tissue comprised by the concavity of the arch and the middle hepatic vein will be segment 4. On the convex-... 

Fig. 4.14. Dissection specimen of the inferior aspect of the left liver. The organ is seen as in Fig. 4.7. The left portal vein has been exposed by opening the peritoneum of the left hepatic pedicle. A horizontal portion and a vertical (umbilical) portion can be recognized. The two portions are separated by Arantius ligament, joining the left portal vein to the left hepatic vein...

Majno PE, Mentha G, Morel P, et al. (2002) Arantius ligament approach to the left hepatic vein and to the common trunk. J Am Coll Surg 195 737-739... 

Fig. 5.1a-d. Sequential CT scan through the liver with Couinaud s segments divided and numbered. RHV, right hepatic vein MHV, middle hepatic vein LHV, left hepatic vein IVC, inferior vena cava RPV, right portal vein LPV, left portal vein FL, falciform ligament... 

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