Abstract          Knowledge of surgical anatomy of liver and its associated variations is prerequisite in liver transplantation surgeries. In the right lobe transplantation, the hepatectomy line passes approximately 1 cm to the right side of the middle hepatic vein as a standard procedure. In surgery after transplantation of liver, venous reconstruction-anastomosis is done. Variations in the drainage pattern of hepatic veins have been reported from time to time. Awareness of associated anatomical variations is important for avoidance of potential surgical complications. We conducted a retrospective multi-slice spiral CT study of hepatic veins, whereby, we studied 100 abdominal CT scans which were reported as normal. We studied the length and the number of branches of hepatic veins and measured the distance of their peripheral-most branch from the nearest hepatic surface. We also studied if any accessory hepatic vein was present. We observed that right hepatic vein was longest (mean length-131.26mm) hepatic vein followed by middle (mean length-122.62mm) and last of all, the left (mean length- 93.15mm) hepatic vein. Most of the right (46%) and middle (45%) hepatic veins were visualized up to third order while most of the left (42%) hepatic veins were having less branches and were visualized up to second order. Most of the right (45) and left (49) hepatic veins were 10-15mm from the hepatic surface while most of the middle hepatic vein wasin the range of 15-20mm. We found Accessory hepatic veins in 18% of cases. Hence it is necessary to evaluate hepatic venous architecture preoperatively in surgeries like liver transplantation and hepatectomy.
Key Words: Accessory hepatic vein, hepatic veins, LDLT, multi-slice spiral CT scan.