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Liver Diseases
Overview
General Description
- Largest Solid Organ in the Body.
- Dimensions: Laterally: 25 cm, Anteroposteriorly: 15 cm, Vertically: 6 cm.
- Shape: Irregular wedge, thick and blunt on the right, flat and narrow on the left, located in the right hypochondrium, with a small portion crossing the sternum.
Segmentation
- Gross Segmentation:
- 4 lobes, 2 surfaces: Falciform ligament divides the liver into right and left lobes + caudate lobe and quadrate lobe.
- Vascular Coarse Segmentation:
- 5 lobes, 6 segments.
- Couinaud Segmentation:
- Two halves, 8 segments: (1-8, caudate left and right) caudate, left lateral superior, left lateral inferior, left medial, right anterior inferior, right posterior inferior, right posterior superior, right anterior superior.
Liver Ligaments
| Name | Description |
|---|---|
| Falciform Ligament | In front, the ligament dividing the right and left lobes anatomically |
| Round Ligament of the Liver | Remnant of the umbilical vein |
| Coronary Ligament | Above, diaphragmatic side, surrounds the bare area of the liver |
| Triangular Ligaments | Divided into left and right |
| Hepatoduodenal Ligament | Connects to the first part of the duodenum, contains the first porta hepatis |
| Hepatogastric Ligament |
Surgical Procedures
- Segmentectomy: Generally performed based on the distribution of intraparenchymal vessels.
- Combined Segmentectomy: Removal of two or more liver segments.
Concept of the Porta Hepatis
- First Porta Hepatis: Location where the hepatic artery, portal vein, and bile duct enter and exit the liver.
- Second Porta Hepatis: Region where the right, middle, and left hepatic veins join the inferior vena cava at the posterior upper margin of the liver (sometimes described as the region where the hepatic veins exit the liver).
- Third Porta Hepatis: (Variation) Region where the short hepatic veins join the inferior vena cava.