Variations in the drainage pattern of the hepatic veins into the inferior vena cava: A cadaveric study

Background: Hepatic veins, which are a link between portal and systemic circulation, traverse the liver substance and drain different segments into the inferior vena cava (IVC). This venous outflow is important for adequate functioning of liver homeostasis. The knowledge of the variations in the number and pattern of openings of the hepatic veins into the floor of IVC is necessary, especially during liver resection and liver transplantation, particularly to decide the method that would be adopted for these aforesaid procedures. Methods: A total of 84 livers present in the Department of Anatomy, Goa Medical College, Goa, were used, from which 9 were excluded. The livers were formalin-fixed and were obtained from donated cadavers. The posterior wall of a retro-hepatic segment of IVC was incised to examine the count of hepatic venous vasculature and the pattern of their openings. Results: The number of hepatic vein openings ranged from 3 to 8. The majority of the livers (32%) had 6 openings. The incidence of the right major hepatic vein was 97.3%, the middle major hepatic vein was 73.3%, and the left major hepatic venous vasculature was 86.6%. The majority of the specimens (n = 25) showed a double opening pattern with 1 separate opening for the hepatic vein of the right side and the middle and left hepatic vein opened by a single trunk. Conclusion: Hepatic venous vasculature showed numerous variations in its draining pattern in the IVC. Understanding these variations is important for hepatic surgeries to improve post-operative outcomes.