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Chapter 10 ♦ Liver, Gallbladder, and Biliary Tree Disorders

Inferior vena cava

Right hepatic vein

Left and intermediate (middle) hepatic veins

II

VII

3°

VIII

3°

T

I

3°

IV

III

3°

2°

3°

2°

U

Portal vein Right and left (1°) branches of hepatic artery Hepatic artery Portal triad Bile duct

VI

M

V

Gallbladder

U = Umbilical fissure 2° = Secondary branches of portal triad structures 3° = Tertiary branches of portal triad structures Anterior view

R

M = Main portal fissure R = Right portal fissure T = Transverse hepatic plane

A

Cantlie line

VIII

VII

II

IV III

Right liver

V

VI

Left liver

B Anterior view

D Anterior view

Gallbladder

Caudate lobe

Vena cava

V GB

IV III

VI

II

I

VII

Right lobe

Left lobe

VIII

C Anterior view

E Inferior view

Gallbladder

Figure 10-1: Segmental liver anatomy. GB, gallbladder. Liver segments are indicated by their corresponding roman numeral. (From Moore KL, Dalley AF, Agur AM: Clinically Oriented Anatomy , 8th ed. Wolters Kluwer Health, 2017, Fig. 5-67.)

C. Storage: Gallbladder, which absorbs water and electrolytes, concentrating bile by tenfold. D. Release: 1. Requires simultaneous contraction of the gallbladder and relaxation of the sphincter of Oddi. 2. Regulated by cholecystokinin (CCK), vagal and splanchnic nerves.