What Is the Hepatic Portal Vein?

. Hepatic portal vein: Also known as portal vein. A thick vein that is collected by the capillaries of the digestive tract (stomach, intestine, pancreas, spleen, etc.) and enters the liver from the hilum. The characteristic is that both ends are connected with capillaries. After the hepatic portal vein enters the liver, it gradually branches to form the hepatic sinus (capillaries of the liver), and then is injected into the posterior (inferior) cavity via the hepatic vein. Venous trunk leading non-paired organs of the abdominal cavity [stomach, spleen, pancreas, intestine (except the posterior rectum)] into the liver. The spleen vein, anterior mesenteric vein, posterior mesenteric vein, and gastroduodenal vein merge; they pass through the pancreatic ring, enter the liver with the hepatic artery, branch in the liver, and join the branch with the branch of the hepatic artery The sinuses are then assembled into the hepatic vein and then into the posterior vena cava. Because the blood in the back of the rectum flows back into the internal iliac vein, drugs that are harmful to the liver or reduce the efficacy of the drug through the liver are often administered clinically rectally. It is 6 to 8 cm long and 1.25 cm in diameter. It is formed by the confluence of the superior mesenteric and splenic veins behind the head of the pancreas. Enter right into the hepatoduodenal ligament, reach the hepatic hilum in the direction of the common bile duct and the hepatic artery, and divide the left and right branches into the left and right lobe of the liver.

. Hepatic portal vein: Also known as portal vein. A thick vein that is collected by the capillaries of the digestive tract (stomach, intestine, pancreas, spleen, etc.) and enters the liver from the hilum. The characteristic is that both ends are connected with capillaries. After the hepatic portal vein enters the liver, it gradually branches to form the hepatic sinus (capillaries of the liver), and then is injected into the posterior (inferior) cavity via the hepatic vein. Venous trunk leading non-paired organs of the abdominal cavity [stomach, spleen, pancreas, intestine (except the posterior rectum)] into the liver. The spleen vein, anterior mesenteric vein, posterior mesenteric vein, and gastroduodenal vein merge; they pass through the pancreatic ring, enter the liver with the hepatic artery, branch in the liver, and join the branch with the branch of the hepatic artery The sinuses are then assembled into the hepatic vein and then into the posterior vena cava. Because the blood in the back of the rectum flows back into the internal iliac vein, drugs that are harmful to the liver or reduce the efficacy of the drug through the liver are often administered clinically rectally. It is 6 to 8 cm long and 1.25 cm in diameter. It is formed by the confluence of the superior mesenteric and splenic veins behind the head of the pancreas. Enter right into the hepatoduodenal ligament, reach the hepatic hilum in the direction of the common bile duct and the hepatic artery, and divide the left and right branches into the left and right lobe of the liver.

Chinese name

Hepatic portal vein

Foreign name

hepatic portal vein

Definition

The trunk of the hepatic portal vein

Types of

Biological veins

Length

6-8cm

Diameter

1.0-1.2cm

Hepatic portal vein overview

Portal vein: There are two meanings: If the ends of a vein are capillaries, the vein trunk is called the portal vein; The liver portal vein is a short and thick vein trunk, which is 6 to 8 cm in length. It is formed by the convergence of the superior mesenteric and splenic veins behind the head of the pancreas. Venous blood was collected from the ventral end of the esophagus, stomach, small intestine, large intestine (to the upper rectum), pancreas, gallbladder, and spleen. Its main physiological function is to transport the substances absorbed by the intestine to the liver for synthesis, detoxification, storage, and secretion of bile. When the portal vein has a circulatory disorder, the blood is susceptible to reflux and portal hypertension occurs.

Hepatic portal vein and portal vein related diseases

1. Diffuse liver cancer with hepatic portal vein thrombosis:

Invasion of liver portal vein system and tumor thrombus formation are the most important forms of liver cancer intrahepatic spread, and also the main factors affecting patient prognosis and interventional treatment. The probability of liver portal vein invasion and tumor thrombus formation is related to the type of liver cancer, the size of the lesion, and the length of the disease. More than 90% of diffuse liver cancers are complicated by intrahepatic portal vein thrombosis, and more than 70% of massive nodular liver cancers have hepatic portal vein invasion and tumor thrombosis, while nodular liver cancers rarely occur, only about 3%. Invasion of portal vein of liver cancer is more common in branch blood vessels, but it can also invade the trunk. Tumor thrombosis in different parts of the hepatic portal vein is related to the location of the tumor. Tumors in the right lobe often involve the right branch and trunk of the hepatic portal vein, while tumors in the left lobe often involve the left branch and the trunk of the hepatic portal vein.

CT manifestations:

Plain scan shows that the density of hepatic portal vein tumor emboli is not significantly different from or slightly lower than blood density. The affected hepatic portal vein is widened and the ratio to the trunk or branch is imbalanced. Enhanced scan shows low density nodules or Hepatic portal vein is not strengthened; small reticular abnormally strengthened collateral circulation vessels can be seen around the liver portal vein; has other CT features of liver cancer.

Differential diagnosis: Hepatic portal vein thrombosis should be distinguished from hepatic portal vein thrombosis caused by other causes. Hepatic portal vein thrombosis is rare, and is often accompanied by other diseases such as acute pancreatitis, high blood coagulation status, etc., its performance is mostly limited to the liver portal vein trunk or large branches, and can also extensively affect the entire hepatic portal vein system, resulting in A large number of collateral blood vessels are formed without evidence of liver cancer. For liver venous emboli in patients with liver cirrhosis after hepatitis, liver cancer should be highly suspected, but when using spiral CT and ultra-high-speed CT to scan in a fast spiral manner, it should avoid misdiagnosing the part of the liver portal vein that is not filled with contrast Emboli formation.

Applied anatomy of hepatic portal vein

At present, for the defoliation of the liver, Couinand's liver segmentation method is mostly used, that is, liver segmentation is performed according to the distribution law of the Glisson system and the hepatic veins. In the Glisson system, the portal vein is the thickest, and the travel position and distribution range are relatively constant, with less variation. Therefore, it is often used as the basis for leaf segmentation. However, when the trunk of the hepatic portal vein and its main branches are mutated, the Couinaud liver segment cannot truly reflect the internal anatomical structure of the liver, leading to incorrect imaging positioning and affecting the formulation and accurate implementation of liver surgery plans. Therefore, it is necessary to master the morphological data of the hepatic portal vein, especially the variation of the branch of the hepatic portal vein, which has great guiding significance for liver surgery.

Bifurcation of the portal vein of the liver:

In the first hepatic hilum, the outer diameter of the main segment of the hepatic portal vein is (10.86 ± 2.01) mm. 54.0% of the hepatic portal vein trunk is bifurcated outside the liver parenchyma, and the vertical distance from the bifurcation point to the liver parenchyma is (8.79 ± 3.35) mm. 34.0% of the liver portal vein trunk is bifurcated close to the liver parenchyma, and 2.0% of the portal vein trunk is entering Fork about 2.5 mm after the liver parenchyma.

Types of hepatic portal vein branches:

According to Couinaud and Atri et al.

The following types:

Type I: Two branches accounted for 80.0%, that is, left and right branches.

Type : Three branches accounted for 6.0%, that is, the hepatic portal vein trunk was divided into left branch, right anterior lobe branch and right posterior lobe branch at the same time.

Type : 4.0%, that is, the hepatic portal vein trunk first sends out the right posterior lobe branch, and then continues to ascend into the right anterior lobe branch and the left branch.

Type : 2.0%, that is, after the right posterior lobe branch of the hepatic portal vein is separated from the hepatic portal vein, the left hepatic portal vein trunk continues to the left branch main branch, and the right anterior lobe branch is branched from the left hepatic portal vein branch.

Type V: 2.0%, that is, the left branch of the hepatic portal vein is missing.

In addition, this study also found that a bifurcation type accounted for 4.0%, that is, the hepatic portal vein trunk was first divided into the right posterior lobe branch and the other trunk, and then this trunk was divided into the left and right anterior lobe branches. Tentatively defined as ; in one case, the trunk of the hepatic portal vein issued the right posterior lobe branch and the left branch successively, and then continued to the right anterior lobe branch, which accounted for 2.0%, and was classified as the type; the type was not seen, that is, the bifurcation type.