The document provides an overview of the surgical anatomy of the liver. It discusses the historical background of liver transplantation and key facts about the liver. The liver's functions, embryology, blood supply, segments, ligaments, recesses, and surgical techniques like hepatectomy are summarized. A good knowledge of liver anatomy is essential for modern hepatic surgery.
Surgical Anatomy of the Liver : Ηepatectomies - Dimitris P. KorkolisDimitris P. Korkolis
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- It is exocrine(bile) & endocrine organ(Albumin , prothrombin & fibrinogen)
Function of the liver :
- Secretion of bile & bile salt
- Metabolism of carbohydrate, fat and protein
- Formation of heparin & anticoagulant substances
- Detoxication
- Storage of glycogen and vitamins
- Activation of vita .D
Surgical Anatomy of the Liver : Ηepatectomies - Dimitris P. KorkolisDimitris P. Korkolis
- The liver is the largest gland in the body and has a wide variety of functions
- Weight: 1/50 of body weight in adult & 1/20 of body weight in infant
- It is exocrine(bile) & endocrine organ(Albumin , prothrombin & fibrinogen)
Function of the liver :
- Secretion of bile & bile salt
- Metabolism of carbohydrate, fat and protein
- Formation of heparin & anticoagulant substances
- Detoxication
- Storage of glycogen and vitamins
- Activation of vita .D
Celiaco Mesenteric Trunk - A Case ReportIOSR Journals
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Variations In Branching Pattern Of Coeliac Trunkiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Anatomical Variation of the Coeliac Trunk A Case Reportijtsrd
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This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
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June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
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2. HISTORICAL BACKGROUND
HEROPHILUS OF CHALCEDON (334-280 B.C.) First anatomical description of liver
THOMAS STARZL: Performed first successful human ORTHOTOPIC liver transplant in
1968
HENRI BISMUTH: Performed first HETEROTOPIC liver transplant in humans in 1980
J. CANTLIE 1897 Confirmed rex's findings. rex's lobular plane of division later named
cantlie's line.
3. FEW FACTS : LIVER
Second largest organ of body after skin.
Average weight : 1.5kg ( 2 % of total body weight) Largest gland.
Position – b/w 5th ICS & costal margin.
Blood flow : 1500 ml/min (25% of CO).
Blood supply : 1/3rd hepatic artery(20%) , 2/3rd portal vein(80%).
4. FUNCTION OF THE LIVER
Secretion of bile (salt and pigments)
Metabolism of carbohydrate, fat and protein.
Formation of heparin & anticoagulant substances.
Detoxication.
Storage of glycogen and vitamins.
Activation of vitamin D.
5. EMBRYOLOGY
4TH WEEK OF DEVELOPMENT
Projection from ventral wall of distal end of
foregut.
Cranial bud - liver
Caudal bud - gallbladder,
extrahepatic biliary tree
Ventral pancreas
6. EMBRYOLOGY
Bile ducts develop from hepatocytes,
Originating at hilum
Biliary lumen recanalize 7th week
Liver begins to secrete bile 12th week
13. THE LIGAMENTUM
VENOSUM
Fibrous band that is the remains of the
ductus venosus
Ligament of aranthius
It is attached to the left branch of the portal
vein and ascends in a fissure on the visceral
surface of the liver to be attached above to
the inferior vena cava
15. HEPATIC ARTERY
Cautions
Only 55-65% of population has
“normal” hepatic arterial anatomy
Aberrant R hepatic artery may be
mistaken for cystic artery
Cystic artery may originate from the
Gastroduodenal artery, the left hepatic
artery, or the common hepatic artery
18. LIVER HISTOLOGY
Lobules >> roughly hexagonal
structures consisting of
hepatocytes. Radiate outward from
a central vein.
At each of the six corners of a
lobule is a Portal triad (
p.Arteriole,p.Venule & bile duct)
Between the hepatocytes are the
liver sinusoids.
20. BILIARY SYSTEM
TRIANGLE OF CALOT
Cystic duct, common hepatic duct, and
hilum of liver.
Dissected during cholecystectomy.
Contents- cystic duct and artery, lymph
node of Lund
24. HEPATIC RECESSES
ANATOMICAL SPACES BETWEEN THE LIVER AND SURROUNDING
STRUCTURES.
INFECTION MAY COLLECT IN THESE AREAS, FORMING AN
ABSCESS.
SUBPHRENIC SPACES – BETWEEN THE DIAPHRAGM AND THE
ANTERIOR AND SUPERIOR ASPECTS OF THE LIVER.
DIVIDED INTO A RIGHT AND LEFT BY
FALCIFORM LIGAMENT.
SUBHEPATIC SPACE – PERITONEAL SPACE IS LOCATED BETWEEN
THE INFERIOR SURFACE OF THE LIVER AND THE TRANSVERSE
COLON.
25. MORISON’S POUCH
A POTENTIAL SPACE BETWEEN VISCERAL
SURFACE OF THE LIVER AND THE RIGHT KIDNEY.
DEEPEST PART OF THE PERITONEAL CAVITY
WHEN SUPINE (LYING FLAT),
THEREFORE PATHOLOGICAL ABDOMINAL FLUID
SUCH AS BLOOD OR ASCITES IS MOST LIKELY TO
COLLECT IN THIS REGION IN A BEDRIDDEN
PATIENT.
31. RISE AND DEMISE OF SEGMENT IX
FOR SEVERAL YEARS COUINAUD AND HIS COLLEAGUES, AS WELL AS SEVERAL
OTHER INVESTIGATORS, REFERRED TO AN AREA OF THE DORSAL SECTOR OF THE
LIVER CLOSE TO THE IVC AS "SEGMENT IX."
BUT THE EXISTENCE OF THIS SEGMENT WAS SHORT-LIVED WHEN, IN 2002,
COUINAUD AND HIS ASSOCIATES PUBLISHED THE FOLLOWING
CONCLUSION:
BECAUSE NO SEPARATE VEINS, ARTERIES, OR DUCTS CAN BE DEFINED FOR THE
RIGHT PARACAVAL PORTION OF THE POSTERIOR LIVER AND BECAUSE PEDICLES
CROSS THE PROPOSED DIVISION BETWEEN THE RIGHT AND LEFT CAUDATE,
THE CONCEPT OF SEGMENT IX IS ABANDONED.
32. ΗEPATECTOMY
Liver tissue has remarkable powers of
regeneration and major resection are well
tolerated.
To preserve the viability of the liver
following surgery, resection follow parellel
to hepatic veins and leaving portal traid.
Segmental or non segmentaal
33. DIVISION OF HEPATECTOMY
FIRST ORDER DIVISION
Based on LOBES (R OR L)
SECOND ORDER DIVISION
Based on BILE DUCT and HEPATIC ARTERY
THIRD ORDER DIVISION
Based on SEGMENTS (1 to 8)
FOUTH ORDER DIVISION (alternative to 2nd order division)
Based on PORTAL VEIN