Dr MHA Bemelmans, ESCAM (European Surgical Center Aachen Maastricht) Surgical Anatomy of the liver Uniklinik RWTH Aachen
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Dr MHA Bemelmans,
ESCAM (European Surgical Center Aachen Maastricht)
Surgical Anatomy of the liver
Uniklinik RWTH Aachen
Uniklinik
RWTH Aachen
ESCAM
Disclosures
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Potential conflict of interest None
Potentially relevant company relationships in
connection with event
None
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Marc
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The cell lineage steps during hepatic development (red) from
uncommitted endoderm to functional adult hepatocytes and
biliary epithelium
Time line mouse liver development
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Adult liver
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Galen (circa 130–200 BC) was one of the
first who described the liver. He thought that
the liver was five-lobed. Such opinion
dominated until the 15th century.
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Vesalius founder modern anatomy (1514-1564)
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1st book on human anatomy Vesalius
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In 1654, F. Glisson (1597–1677) studied the
liver. He discussed topography of the
intrahepatic vessels and surrounding
connective tissue. Even today this is
referred to as Glisson’s capsule and the triad
(portal vein, biliary duct and hepatic artery)
is called portal pedicle or Glisson’s pedicle
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Francois Glisson
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1597-1677
N. A. Goldsmith and R. T. Woodburne
supported division of the liver into four
segments, each having two subsegments
with second order of portal vein branches
(1957)
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C. Couinaud suggested that the liver should
be divided into eight segments, based on
third order portal vein distribution (1957)
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Claude Couinaud
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A good knowledge of the anatomy
is a prerequisite for modern surgery
of the liver.”
H. Bismuth
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Henri Bismuth
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Porto Allegre Brasil 2016
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Bismuth’s classification. H. Bismuth brought
together the Couinaud’s cadaveric system in
situ and the system of Goldsmith and
Woodburn in vivo
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He distinguished three planes (scissurae),
hosting the hepatic veins and a transverse
plane passing through the right and left
portal branches. Additionally, H. Bismuth
described the caudate lobe as a separate
segment I.
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Anatomy according to Bismuth
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Anatomy 1
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Anatomy 2
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Anatomy 3
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Anatomy 4
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Anatomy 5
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Anatomy 6
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Anatomy 7
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Anatomy 9
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VIDEO???
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Cirrhosis
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Anatomy 10
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No comment
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Arterial anatomy
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Portal Anatomy
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Biliary Anatomy
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Anatomy 11
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Anatomy 12
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Anatomy 13
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Anatomy 14
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Majno et all j Hepatol 2014
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