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The rationale for this approach is that minute residual bile duct remnants may be present in the fibrous tissue of the porta hepatis and thus provide direct connection with the intrahepatic ductule system to allow bile drainage. [2] This procedure was developed in 1951 by Japanese biliary and hepatic pediatric surgeon Morio Kasai (1922–2008).
Access to the porta hepatis: The Kocher manoeuvre allows access to the porta hepatis, the gateway to the liver. By mobilizing the duodenum and pancreas, surgeons gain exposure to the structures in the hepatic portal area. Exposure of hepatoduodenal ligament: The procedure facilitates the dissection and exposure of the hepatoduodenal ligament.
The porta hepatis or transverse fissure of the liver is a short but deep fissure, about 5 cm long, extending transversely beneath the left portion of the right lobe of the liver, nearer its posterior surface than its anterior border.
The hepatoduodenal ligament is the portion of the lesser omentum extending between the porta hepatis of the liver and the superior part of the duodenum. [citation needed] Running inside it are the following structures collectively known as the portal triad: [1] hepatic artery proper; portal vein; common bile duct
Ultrasonography (US) is the first-line imaging technique for the diagnosis and follow-up of portal hypertension because it is non-invasive, low-cost and can be performed on-site. [ 17 ] A dilated portal vein (diameter of greater than 13 or 15 mm) is a sign of portal hypertension, with a sensitivity estimated at 12.5% or 40%. [ 18 ]
Diet: A high-calorie diet is recommended. [17] Many people develop nausea and cannot tolerate food later in the day, so the bulk of intake may be concentrated in the earlier part of the day. [ 17 ] In the acute phase of the disease, intravenous feeding may be needed if patients cannot tolerate food and have poor oral intake subsequent to nausea ...
The quadrate lobe is an area of the liver situated on the undersurface of the medial segment left lobe (Couinaud segment IVb), bounded in front by the anterior margin of the liver, behind by the porta hepatis, on the right by the fossa for the gall-bladder, and on the left by the fossa for the umbilical vein.
The portal vein or hepatic portal vein (HPV) is a blood vessel that carries blood from the gastrointestinal tract, gallbladder, pancreas and spleen to the liver.This blood contains nutrients and toxins extracted from digested contents.