RESUMO
Introduction: The right hepatic lobe transplantation is usually the procedure of choice to provide adequate livervolume to the recipient. Variant vascular and biliary anatomy is more common in the right lobe. Knowledge ofanatomical variants is valuable in preoperative planning, particularly in considering donor candidates foradult-to-adult liver transplantation, whereby typically the right lobe of the donor is transplanted to the recipient.The present study was done to identify the branching patterns of right portal vein and to know their importancein management of living donor liver transplantation surgeries.Material and Methods: The present study was conducted on 84 liver specimens of human cadavers fixed with10% formalin, collected from the Department of Anatomy and Forensic Medicine, MMC&RI, Mysore.Results: Bifurcation of RPV was seen in 30 specimens (35.7%). Trifurcation of RPV was seen in 5 specimens (6%).Quadrification of RPV was seen in 18 specimens (21.4%). Arched pattern of RPV was seen in 15 specimens(17.9%). Premature origin of segment V and segment VIII vein from RPV, then trunk of RPV dividing terminally intosegment VI and segment VII vein was seen in 2 specimens (2.4%). Unusual pattern of division of RPV was seen in10 specimens (12%). In rest of 4 specimens there was no RPV as Right anterior and Right posterior portal veinswere directly arising from Main portal vein.Conclusion: Anatomical variations of the liver vasculature and bile ducts are common and their recognition andmanagement is critical in living donor liver transplantation. Although anomalies of the right lobe are commonlyencountered, a relatively limited number of cases will significantly complicate the resection and transplantation.Main advantage of right lobe transplantation is the large size of graft and surgical management of both donorand recipient anatomical variations is considerably simpler than with left sided graft
RESUMO
Background: Asterion is the meeting point of temporal, occipital and parietal bones on the posterolateral surface of skull and surgically an important point of reference for approaching the posterior cranial fossa structures. However surgeons have been skeptical about its reliability due to population based differences in its morphology, distance with other external landmarks and also to sigmoid and transverse sinuses. Methods: In this study 50 (27 male & 23 female) adult skulls were investigated to determine the type of asterion, its distance from important bony landmarks and also the nearby venous sinuses were measured. Results: Our study revealed that type II (absence of sutural bones) was commoner than type I (presence of sutural bones) asterion. The asterion was 4.82 ± 0.58 cm from tip of the mastoid process on the right side and 4.70 ± 0.70 cm on the left. It was greater in males than in females, p value being statistically significant (P = 0.00 & P = 0.02 for right & left sides respectively). The distance of asterion from supramastoid crest was 4.22 ± 0.73 cm on the right and 4.23+/-0.58 cm on the left. The distance in males was more than in females. The P value 0.00 was statistically significant on the right side. Regarding the position of the asterion in relation to transverse sinus, it was on the transverse sinus in 62% cases, below it in 32% and above in 6%. Conclusions: The data obtained shows that the asterion is located either at the level or below the level of the transverse sinus in majority of the cases. This information is useful to neurosurgeons to reduce the risk during posterior cranial fossa surgeries. This work will also be useful to anthropologists, forensic science experts for determination of sex of the skull along with other parameters.