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KITAJIMA Kumiko
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Assistant Professor |
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| Article types | Original article |
| Language | English |
| Peer review | Peer reviewed |
| Title | Fusion of the planes of the liver: an anatomic entity merging the midplane and the left intersectional plane. |
| Journal | Formal name：Journal of the American College of Surgeons Abbreviation：J Am Coll Surg ISSN code：10727515/10727515 |
| Domestic / Foregin | Foregin |
| Volume, Issue, Page | 200(5),pp.711-9 |
| International coauthorship | International coauthorship |
| Author and coauthor | Savier Eric, Taboury Jacques, Lucidarme Olivier, Kitajima Kumiko, Cadi Mehdi, Vaillant Jean-Christophe, Hannoun Laurent |
| Publication date | 2005/05 |
| Summary | BACKGROUND:Alignment of the gallbladder fossa and the round ligament may be associated with an almost unknown portal vein branching anomaly.STUDY DESIGN:Ultrasonographic imaging allowed detection of this anomaly, which we characterized as fusion of the planes of the liver. When appropriate, additional specific radiologic examinations were performed (CT scanner supplemented with a three-dimensional reconstruction, a biliary cartography, or an angiography). Surgical consequences were studied from this series and from the literature.RESULTS:Seven patients (0.5%) had the following criteria: 1) round ligament, gallbladder fossa, and termination of the portal vein occurring in the same plane; 2) typical portal vein branching, including a right posterior branch, left branches, and a main medial branch terminated by the Rex's recessus; 3) two main hepatic veins without a significant middle hepatic vein; and 4) absence of the horizontal part of the left hepatic duct. Fusion of the planes may have been involved in two cases of iatrogenic bile duct injury and contraindicated a tumor resection and a right-liver donation. A review of the literature revealed that lack of recognition of the fusion of the planes led to a high proportion of surgical iatrogenic injury. Fusion of the planes could result from incomplete development of the central part of the liver, in agreement with embryologic knowledge.CONCLUSIONS:Knowledge of the fusion of the planes by hepato-biliary surgeons is important. This anomaly may lead to serious complications if it remains undetected during liver resection or bile duct surgery. |
| DOI | 10.1016/j.jamcollsurg.2004.12.017 |
| PMID | 15848361 |