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06-06-2008, 09:27 PM
m General
The liver is the largest organ in the body, weighing 1.5 kg in 70-kg male.
Its position under the right copula of diaphragm allows it to be protected from trauma by the costal margin.
The liver parenchyma is entirely covered by a thin capsule and by visceral peritoneum in all but the posterior surface of the liver, termed the bare area.
m Ligaments and Peritoneal Reflections
1. The left triangular ligament on the superior surface of the left lobe. Dividing this ligament allows the left lobe to be mobilised from the diaphragm and the left lateral wall of the inferior vena cava (IVC) to be exposed.
2. The right triangular ligament fixes the entire right lobe of the liver to the undersurface of the right hemidiaphragm. Division of this ligament allows the liver to be mobilised from under the diaphragm and rotated to the left.
3. The falciform ligament, which runs from the umbilicus to the liver between the right and left lobes, passing into the interlobar fissure. Division of this layer allows exposure of the suprahepatic IVC lying within a thin sheath of fibrous tissue.
4. The lesser omentum is the final peritoneal reflection between the stomach and the liver. It is often thin and fragile but contains the hilar structures in its free edge.
m Blood Supply of the Liver
The blood supply to the liver is unique, being derived 80 per cent from the portal vein and 20 per cent from the hepatic artery.
m Venous Drainage of the Liver
The venous drainage of the liver is via the hepatic veins into the IVC. The vena cava lies within a groove in the posterior wall of the liver. The major venous drainage is through three large hepatic veins which join the IVC immediately below the diaphragm (Right, left and middle veins).
m The Internal Anatomy of the Liver
Safe liver surgery has been enormously facilitated by a better understanding of the internal anatomy of the liver. The liver is divided into a functional right and left lobes along the line between the gall bladder fossa and the middle hepatic vein.
SOURCE: DR. AYMAN SALEM'S BOOK
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