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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).
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 central area or hepatic hilum, includes the opening known as the porta hepatis which carries the common bile duct and common hepatic artery, and the opening for the portal vein. The duct, vein, and artery divide into left and right branches, and the areas of the liver supplied by these branches constitute the functional left and right lobes.
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.
The common hepatic duct is the first part of the biliary tract. [2] It is formed by the union of the right hepatic duct (which drains bile from the right functional lobe of the liver) and the left hepatic duct (which drains bile from the left functional lobe of the liver).
Color Doppler Ultrasound is the most useful imaging tool used to identify aneurysms, thrombosis, and branching patterns of the portal venous system, and to determine if treatment or surgery will be necessary. [5]
Superior—porta hepatis [1] (earlier—confluence of the cystic and common bile duct), [2] Inferior—junction of the second and third portion of duodenum, [2] and; Medial—junction of the neck and body of the pancreas [2] The importance of the triangle is because it is known as the source of origin of most gastrinomas.
In special cases where there is a higher risk with surgery, such as in the elderly, nonoperative management would include the infusion of packed red blood cells in an intensive care unit. [2] Typically hepatic injuries resulting from stab wounds cause little damage unless a vital part of the liver is injured, such as the hepatic portal vein ...