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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.
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]
Transjugular intrahepatic portosystemic shunt (TIPS or TIPSS) is an artificial channel within the liver that establishes communication between the inflow portal vein and the outflow hepatic vein.
An Operative report is a report written in a patient's medical record to document the details of a surgery. [1] The operative report is dictated right after a surgical procedure and later transcribed into the patient's record.
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 ]
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).