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Erschienen in:
10.12.2016 | Anatomic Bases of Medical, Radiological and Surgical Techniques
Identification landmark for right anterior portal pedicle: “the zone of 2 cm”
Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 7/2017
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Purpose/background
Cystic plate is easily visible while right anterior portal pedicle (RAPP) is a difficult to identify due to its intrahepatic location. This study aims to determine the relation between these two structures so as to facilitate rapid identification of RAPP during the operation.
Methods
Thirty-seven cadaveric liver dissections were carried in the Forensic Department at the Charles Nicolle Hospital, Tunisia.
Results
The cystic plate was thin (≤1 mm), medium (1–3 mm), and thick (≥3 mm) in 14 (37.8%), 17 (46%), and 6 cases (16.2%), respectively. RAPP was found to be originating from right, main, and left portal trunk in 29 (78.3%), 6 (16.3%), and 2 (5.4%) livers, respectively. The origin of RAPP was extrahepatic in nine cases (24.3%). RAPP was located underneath the cystic plate in 21 livers (56.8%). Thirteen RAPPs (35.1%) were located to its right at the mean distance of 1.4 cm (range 0.4–2.5). Three RAPPs were present to the left of cystic plate (8.1%) at the mean distance of 0.9 cm (range 0.7–1.3).
Conclusion
Rapid identification of RAPP is possible by knowing its anatomic variations and its relation with cystic plate.