Right Intrahepatic Portal Vein Classification Based on Three-Dimensional Visualization With Particular Attention to the Relevance of the Right Anterior and the Right Posterior Portal Vein.

Abstract

The present study aimed to investigate the branching pattern of the right intrahepatic portal vein, with a particular focus on the third-order portal vein branches, and their clinical implications, utilizing three-dimensional visualization technology. This technology has the potential to assist clinicians in performing hepatectomy. A retrospective analysis on the branching pattern of the third-order portal branch of the right intrahepatic portal vein was conducted in 711 patients, spanning from June 2019 to June 2021, utilizing three-dimensional visualization techniques. With regard to the anatomy of the right anterior portal vein, the cranio-caudal type was found in 353 patients, the ventro-dorsal type in 171 patients, the trifurcation type in 61 patients, and the quadfurcation type in 9 patients. Additionally, the right posterior portal vein was categorized into three types based on the third-order branches: the bow-shaped type was observed in 294 cases, the bifurcation type in 286 cases, and the trifurcation type in 14 cases. Consequently, the branching pattern of the right intrahepatic portal vein was classified into 12 distinct types and four special types, considering the variations in the number and course of the third-order branches originating from the right anterior and posterior portal veins. The results of this study offer valuable insights into the structure of the right intrahepatic portal vein, enhancing clinicians' rational understanding and contributing to the safe execution of hepatic operative planning and decision-making.