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    2 Surgical Lobes - 3 Minor Fissures - 3 Major Fissures - 4 Portal Sectors - 8 Functional Segments

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    Anmol Kudal
    The liver is divided into eight functional segments based on their blood supply. It has four sectors separated by the branches of the portal vein: right lateral, right medial, left medial, and left lateral. Each sector contains two segments except the left medial which contains segments three and four as well as part of segment one. The three major fissures contain the hepatic veins and separate the liver into sectors.

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    2 Surgical Lobes - 3 Minor Fissures - 3 Major Fissures - 4 Portal Sectors - 8 Functional Segments

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    Anmol Kudal
    253 views9 pages
    The liver is divided into eight functional segments based on their blood supply. It has four sectors separated by the branches of the portal vein: right lateral, right medial, left medial, and left lateral. Each sector contains two segments except the left medial which contains segments three and four as well as part of segment one. The three major fissures contain the hepatic veins and separate the liver into sectors.

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    The liver is divided into eight functional segments based on their blood supply. It has four sectors separated by the branches of the portal vein: right lateral, right medial, left medial, and left lateral. Each sector contains two segments except the left medial which contains segments three and four as well as part of segment one. The three major fissures contain the hepatic veins and separate the liver into sectors.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    253 views9 pages

    2 Surgical Lobes - 3 Minor Fissures - 3 Major Fissures - 4 Portal Sectors - 8 Functional Segments

    Uploaded by

    Anmol Kudal
    The liver is divided into eight functional segments based on their blood supply. It has four sectors separated by the branches of the portal vein: right lateral, right medial, left medial, and left lateral. Each sector contains two segments except the left medial which contains segments three and four as well as part of segment one. The three major fissures contain the hepatic veins and separate the liver into sectors.

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    LIVER

    • 2 SURGICAL LOBES
    • 3 MINOR FISSURES
    • 3 MAJOR FISSURES
    • 4 PORTAL SECTORS
    • 8 FUNCTIONAL SEGMENTS
    Anatomical Lobes
    On the diaphragmatic surface
    Right and left, by the attachment of the falciform ligament.
    On the visceral surface
    (a) Right lobe
    (b) Left lobe
    (c) Quadrate lobe
    (d) Caudate lobe
    Physiological Lobes/Functional Lobes
    By an imaginary sagittal plane/line (Cantlie’s plane/line).
    Right and left physiological (surgical lobes)
    On the posteroinferior surface this plane passes through the fossa for gallbladder, to
    the groove for IVC.

    Note: Caudate lobe is equally shared between the right and left lobes.
    Fissures of the liver
    Three major fissures (main, left and right portal fissures), not visible on the surface,
    run through the liver parenchyma and contain the three main hepatic veins.
    1. Main portal fissure
     Sometimes called Cantlie's line
     Contains middle hepatic vein
     It separates the liver into right and left hemi-livers.
    2. Left portal fissure
     Divides the left hemi-liver into medial (anterior) and lateral (posterior) sectors.
     It contains the left hepatic vein
    3. Right portal fissure
     Divides the right hemi-liver into lateral (posterior) and medial (anterior) sectors.
     Contains right hepatic vein

    Three minor fissures are visible as physical clefts of the liver surface.
    1. Umbilical fissure (or fissure for the ligamentum teres)
    2. Venous fissure (or fissure for the ligamentum venosum)
    3. Fissure of Gans (or Rouvière’s sulcus) lies on the under surface of the right lobe of
    the liver behind the gallbladder fossa
    FUNCTIONAL DIVISIONS
    Current understanding of the functional anatomy of the liver is based on Couinaud’s division of
    the liver into eight functional segments.

    The liver is divided into four portal sectors (by the four main branches of the portal vein).
    1. Right lateral
    2. Right medial
    3. Left medial
    4. Left lateral
    (sometimes, the term posterior is used in place of lateral, and anterior in place of medial).

    Note:
     The three main hepatic veins lie between these sectors as intersectoral veins.
     These intersectoral planes are also called portal fissures (or scissures).
     Each sector is subdivided into segments (usually two), based on their supply by tertiary divisions of the
    vascular biliary (Glissonian) sheaths.
    Sectors and segments of the liver
    4 Sectors
    1. Right lateral sector = segments VI and VII
    2. Right medial sector = segments V and VIII
    3. Left medial sector = segments III and IV (and part of I)
    4. Left lateral sector = segment II
    Segments are numbered clockwise from below, starting with segment I and ending with segment VIII
    HANDY MODEL TO REMEMBER SEGMENTS & SECTORS
    Just make a fist with your right hand and tuck the thumb behind the other fingers. (note the thumb
    shadow behind middle finger

    7 8 4a 2

    Right post. sector

    Left lateral sector


    Left medial sector
    Right ant. sector
    1

    6 5 4b 3

    Right hemi-liver Left hemi-liver

    The fingers can then be numbered according to the The creases between the fingers represent the left,
    Couinaud's segments, with the caudate lobe middle and right hepatic veins. The right hepatic vein
    (segment 1) represented by the thumb that is is located between the right anterior and posterior
    tucked away. The PIP joints represent the plane sectors and the left hepatic vein sits between the left
    that the portal vein runs through, with branches medial and lateral sectors. The middle hepatic vein
    going to upper and lower segments is in between the left and right hemi-liver.

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