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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Surgical relevance of anatomic variations of the right hepatic vein
Shamir O Cawich, Vijay Naraynsingh, Neil W Pearce, Rahul R Deshpande, Robbie Rampersad, Michael T Gardner, Fawwaz Mohammed, Roma Dindial, Tanzilah Afzal Barrow
Shamir O Cawich, Vijay Naraynsingh, Fawwaz Mohammed, Department of Surgery, University of the West Indies, St Augustine 000000, Trinidad and Tobago
Shamir O Cawich, Vijay Naraynsingh, Fawwaz Mohammed, Department of Surgery, Port of Spain General Hospital, Port of Spain 000000, Trinidad and Tobago
Neil W Pearce, University Surgical Unit, Southampton General Hospital, Southampton SO16 6YD, United Kingdom
Rahul R Deshpande, Department of Surgery, Manchester Royal Infirmary, Manchester M13 9WL, United Kingdom
Robbie Rampersad, Department of Radiology, University of the West Indies, St. Augustine 000000, Trinidad and Tobago
Robbie Rampersad, Roma Dindial, Tanzilah Afzal Barrow, Department of Radiology, Port of Spain General Hospital, Port of Spain 000000, Trinidad and Tobago
Michael T Gardner, Section of Anatomy, Basic Medical Sciences, University of the West Indies, Kingston 000000, Jamaica
Tanzilah Afzal Barrow, Department of Radiology, University of the West Indies, St Augustine 000000, Trinidad and Tobago
Author contributions: Cawich SO, Gardner MT and Mohammed F designed and coordinated the study; Naraynsingh V, Barrow TA, Dindial R and Rampersad R performed experiments, acquired and analyzed data; Cawich SO, Gardner MT, Mohammed F, Naraynsingh V, Barrow TA, Dindial R and Deshpande RR and Pearce NW interpreted the data; Cawich SO and Gardner MT wrote the manuscript; all authors approved the final version of the article.
Institutional review board statement: The study was reviewed by the institutional board and deemed exempt as it was an observational study on images already obtained during patient care and no changes in clinical management were made due to study protocols.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at TT.liver.surgery@gmail.com. All data are anonymized and risk of identification is low.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Shamir O Cawich, FACS, Professor, Department of Surgery, University of the West Indies, St Augustine Campus, St Augustine 000000, Trinidad and Tobago. socawich@hotmail.com
Received: February 9, 2021
Peer-review started: February 9, 2021
First decision: March 17, 2021
Revised: March 18, 2021
Accepted: May 20, 2021
Article in press: May 20, 2021
Published online: June 18, 2021
ARTICLE HIGHLIGHTS
Research background
Venous drainage from the liver is known to have many variations. The variations have a direct bearing on invasive procedures performed by transplant surgeons, interventional radiologists, and medical practitioners with an interest in treating liver diseases.
Research motivation
The right hepatic vein (RHV) drainage patterns are particularly important in transplantation procedures. Therefore, the RHV variations were evaluated in this study.
Research objectives
The objective of this study was to document RHV drainage patterns. The information would provide important information that would help to optimize outcomes during invasive liver procedures.
Research methods
In this study, 230 contrast-enhanced computed tomography scans were independently examined by two radiologists. The venous drainage patterns were described in three categories: (1) tributaries to the RHV; (2) variations at the hepatocaval junction; and (3) accessory RHVs.
Research results
Conventional anatomic arrangements of the hepatic veins were present in only 39% of the individuals. The anatomic variations we encountered included accessory RHVs (49%), inferior RHV draining segment VI (45%), middle RHV (4%), Nakamura and Tsuzuki type I variations (70.3%), type II variants (20.3%) type III (5.1%) and type IV variants (4.2%).
Research conclusions
There was significant variation in RHV patterns in this population. The variations have great relevance to operative procedures on the liver. Any surgeons performing operations in patients from the Caribbean diaspora must be cognizant of these variations.
Research perspectives
The direction of the future investigations stimulated by this research would be to evaluate other associated anatomic anomalies and to compare the results to global statistics.
