Anatomy and surgical relevance of the hepatocaval ligament. A study on cadaveric livers.

ABSTRACT

BACKGROUND: There are nearly no data on the hepatocaval ligament (HCL) in the anatomical literature, though it is of high importance during surgery of the right hemiliver. AIM: The aim of this study was to determine the frequency of the HCL, its description and its relations to the inferior vena cava (IVC) and the right hepatic vein (RHV) as well as the evaluation of the surgical relevance of the data obtained. MATERIALS AND METHODS: The dissection of the livers of 43 cadavers of both sexes was performed and the presence of the HCL was established. The ligament was measured and dissected to expose the IVC and the extrahepatic part of the RHV from its inflow to the liver parenchyma. RESULTS: The ligament was present in 77% of the cases. It was 12-35 mm long and 3-18 mm wide. The extrahepatic part of the RHV was 2-12 mm long. CONCLUSION: Dissection of the HCL revealed the terminal extrahepatic part of the RHV in all cases. Anatomically, resection of the right hemiliver with elective vascular control would be possible in 85% of the cases in which the length of the extrahepatic part of the RHV was > or =3 mm.