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Tytuł :
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Portal Venous Territories Within the Human Liver: An Anatomical Reappraisal
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Autorzy :
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Jean H. D. Fasel
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Temat :
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Ecology, Evolution, Behavior and Systematics
Histology
Biotechnology
Anatomy
Human liver
Tomography x ray computed
Portal vein
Medicine
business.industry
business
Branching (version control)
First order
ddc:612
Aged
Aged, 80 and over
Corrosion Casting
Female
Humans
Image Processing, Computer-Assisted
Liver/anatomy & histology/blood supply/radiography
Male
Middle Aged
Models, Anatomic
Models, Cardiovascular
Portal Vein/anatomy & histology/radiography
Radiographic Image Interpretation, Computer-Assisted
Tomography, X-Ray Computed
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Źródło :
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Anatomical Record, Vol. 291, No 6 (2008) pp. 636-642
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Wydawca :
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Wiley, 2008.
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Rok publikacji :
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2008
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ISSN :
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1932-8494
1932-8486
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Dostępność :
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https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3dc28397183f0fc6e4672fb641f7382a
https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1002%2Far.20658
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Prawa :
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RESTRICTED
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Numer akcesji :
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edsair.doi.dedup.....3dc28397183f0fc6e4672fb641f7382a
Subdivision of the human liver into eight portal venous segments (according to Couinaud) is largely established in the anatomical and clinical community. However, this concept is challenged by an increasing number of surgical and radiological reports. We reexamined the intrahepatic portal venous architecture to understand the inconsistencies published. For this purpose, we studied the livers of 20 deceased who had donated their body to the Anatomy Department. The organs were investigated by portal venous injection, subsequent liver corrosion, and analysis of the branching pattern. After a usual bifurcation of the portal vein (order 0 vessel) into a right and left branch (first order vessels), the number of second order branches observed was between 9 and 44, with an average of 20. This seemingly trivial matter of fact suggests that the human liver does not consist of the eight segments presumed, but of many more. Supposedly contradictory observations turn out to be explainable by differing combinations of this large number of territories, and not simply by anatomical variability. For practical surgical purposes, we conclude that the useful eight-segment scheme needs conceptual reappraisal when a more realistic approach to the individual hepatic territoriality in the patients under consideration is demanded. We submit a "1-2-20-concept" as a possible key.