Anatomical variations of the hepatic veins: an observational study from a single cadaveric lab in South India

Modern hepatic resections need to consider hepatic vein variations to reduce surgical complications. In this studywe determined the variation in the branching pattern of hepatic veins by modified luminal casting technique and evaluatedthe association of the hepatic vein variations with morphological variations of the liver. The morphological features of thirtyformalin-fixed livers were noted. The branching pattern of the hepatic veins was studied by retrograde injection of siliconeinto the hepatic veins through the inferior vena cava. According to the descriptions given by previous studies, the right,middle, left hepatic veins, and combined middle and left hepatic venous branching patterns were categorized. The data wasanalyzed statistically. The predominant hepatic vein patterns were De Cecchis type I right hepatic vein (30%), Neumann typeI middle hepatic vein (67%), and Reichert type I left hepatic vein (70%). A common trunk for the middle and left hepatic veinwas present in 60% and Wind’s type II was more common (30%) followed by type I (20%) and type III (10%). While there wasno association between the De Cecchis and Wind types, 90% of the conical-shaped livers exhibited type II middle/left hepaticvein pattern of Wind’s classification. The present study also observed a rare variation of an accessory inferior left hepatic vein.