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Pattern of branching of the left portal vein: an anatomo-radiological study

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Abstract

Purpose

Branching variations of the left portal vein can be managed but they may require technical adaptation. The aim of the present study was to investigate the pattern of ramification of the left portal vein in vascular casts and in radiological images.

Methods

50 vascular casts and 200 computed tomography (CT) angiographies of the upper abdomen were analyzed. Analyses of the vascular casts and of the radiological images were conducted to evaluate the morphology of the left liver, the modality of division of the portal vein, and the number of branches destined for segments 2, 3, 4.

Results

In the vascular casts the portal vein presented bifurcation in 75 %, trifurcation in 20 %, and quadrifurcation in 5 %, whereas in the radiological study the portal vein presented bifurcation in 90 % and trifurcation in 10 % of the cases. For segment 2 in the vascular casts, in their CT and in the radiologic in vivo study a number from 1 to 3 branches was found, coming from the medial or posterior aspects of the left portal vein. For segment 3 in the vascular casts, in their CT and in the radiologic in vivo study a number from 1 to 6 branches was found, coming from the posterior and medial aspects of the left portal vein and its the cul-de-sac. For segment 4 in the vascular casts, in their CT a number from 5 to 9 branches was found (in the radiologic in vivo study from 4 to 9), coming from the posterior and ventral aspects of the left portal vein and from its cul-de-sac. No branches were found to come from the lateral aspect of the left portal vein. Moreover, the modality of branching of the left portal vein correlated with the morphology of left liver.

Conclusions

Knowledge of the pattern of branching of the left portal vein is important for surgical purpose. CT angiography is a valuable preoperative examination to visualize the branching pattern of adult patients.

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Acknowledgments

The authors are grateful to Dr Edgardo Enrico Edoardo Picardi, Dr Gloria Sarasin, and Dr Gianpaolo Mornata for their skillful technical assistance and to Dr Giulia Andretta for the revision of English text.

Conflict of interest

The authors state that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Molecular Medicine, Institute of Anatomy, University of Padova, Via A. Gabelli 65, 35127, Padua, Italy

    Veronica Macchi, Andrea Porzionato & Raffaele De Caro

  2. Section of Radiology, Euganea Medica Center, Padua, Italy

    Aldo Morra

  3. Pediatric Surgery, University of Padova, Padua, Italy

    Giovanni Franco Zanon

Authors
  1. Veronica Macchi
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  2. Andrea Porzionato
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  3. Aldo Morra
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  4. Giovanni Franco Zanon
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  5. Raffaele De Caro
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Correspondence to Raffaele De Caro.

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Macchi, V., Porzionato, A., Morra, A. et al. Pattern of branching of the left portal vein: an anatomo-radiological study. Surg Radiol Anat 37, 463–471 (2015). https://doi.org/10.1007/s00276-015-1440-9

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  • DOI: https://doi.org/10.1007/s00276-015-1440-9

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