More precisely, Reichert http://www.selleckchem.com/products/CP-690550.html also stated that a sectioning of the hepatic parenchyma in a plane that was traced to one centimeter to the right of the umbilical fissure will a single duct of the left lobe in 90% of cases (2). In this study however, at the same distance from the ligamentum venosum, a single duct was found in 65% of cases. This finding emphasizes the need for greater caution because at this distance 35% of confluence can still be found. A 1 cm change from the plane of resection, in other words, more than 2 cm to the right side of ligamentum venosum can significantly increase the prevalence of a single duct. Onishi et al, showed that there is an average distance of 9.7 mm between the confluence of the DSII and DSIII and the umbilical portion of the portal vein, but they did not define the patterns of convergence (14).

In our study a greater proximity to the reference point was observed, with an average of 4.74 mm to the right of the ligamentum venosum. Regarding the studies cited above, the ligamentum venosum, despite having close relationship with the umbilical fissure, was shown to be a more frequent parameter due to less variability between the measurements for each sample. Also this ligament has an anatomical location that is easier and more accurate. The influence of hepatic anatomy influences not only the techniques of liver transplantation, but also all surgical procedures that involve resection of the parenchyma of the organ. Currently with the evolution of minimally invasive techniques, the laparoscopic technique is on the rise.

The loss of tactile sensitivity of this technique can be compensated by the accurate determination of the topography of the liver. Conclusions The evaluation of the results shows that it was possible to determine, based on the confluence of the DSII and the DSIII, the biliary drainage of the left anatomical lobe of the liver through four patterns. The most frequent pattern showed the confluence of the ducts in a location that is more medial and to the right of the ligamentum venosum. Regarding the specific objectives of this study we have: The confluence of the DSII and the DSIII, with the most significant prevalence at 2.5 cm from the ligamentum venosum. The average distance was 4.74 mm to the right of the same ligament. The confluence of LHD and RHD met at a point 35.22 mm from the ligamentum venosum, on average.

The confluences of the LHE and RHS and the DSII and the DSIII were at a distance of 30.51 mm on average. The LHD was shown to have an anatomy with fewer anatomical variations than that of the RHD. DSI was shown to have varying aspects, including drainage for the RHD in some cases. However the presence of two ducts Cilengitide draining this segment was the most common. Segment IV was drained into the LHD in all the cases, and it was mostly drained by only one duct.