The hilum of the liver

The hilum of the liver

The porta hepatis is a pronounced transverse fissure on the visceral surface of the liver running between the cephalad end of the fissure for the ligamentum teres and the gallbladder fossa. The neurovascular structures and lymphatics running in the right free edge of the lesser omentum (the hepatoduodenal ligament) enter at this point and the right and left hepatic ducts emerge. There are numerous variations of the hilar structures which are important in the planning and performance of operations on the liver ( Figure 69.2 ). In the most common arrangement, the bile duct runs in the free edge of the hepatoduodenal ligament with the hepatic artery medially and the portal vein posteriorly , each dividing into two branches at the hilum. The right and left hepatic ducts arise from the hepatic parenchyma and form the common hepatic duct. The cystic duct draining the gallbladder enters the ligament at a variable level, joining the common hepatic duct to form the common bile duct (CBD). The right hepatic A hilum is a depression or fissure where nerves, vessels or ducts enter a bodily organ. Sir James Cantlie , 1851–1926, Scottish-born physician who cofounded the Hong Kong College of Medicine for Chinese (now Hong Kong University School of Medicine). artery crosses the bile duct anteriorly or posteriorly before giv - ing rise to the cystic artery , and multiple branches predomi - nantly from the right hepatic artery supply the bile duct. The portal vein is formed by the confluence of the splenic and supe - rior mesenteric veins behind the neck of the pancreas, with the left branch having a longer (approximately 2 /uni00A0 cm) extrahe patic course. The portal vein often has two large branches to the right lobe, w hich are usually outside the liver for a short length, - before giving a left portal vein branch that runs behind the left hepatic duct.

II VIII VII IV I III V VI (a) As seen in the patient.