Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202401101
Jornal Vascular Brasileiro
Original Article

Variações anatômicas na circulação hepática: estudo em 500 tomografias computadorizadas de abdome

Variations in hepatic circulation: a study of 500 abdominal computed tomography scans

Maria Eduarda Zen Biz; Jéssica Paola Salame; Gustavo Gumz Correia; Rafael Saviolo Moreira

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Resumo

Contexto: O conhecimento sobre a anatomia vascular do fígado e outros órgãos abdominais auxilia o cirurgião a realizar um melhor planejamento pré-operatório, obter maior sucesso cirúrgico, prevenir complicações e diminuir a morbimortalidade.

Objetivos: Relatar a prevalência de variações anatômicas da artéria hepática própria e da veia porta, observadas em exames de tomografia computadorizada.

Métodos: Trata-se de um estudo retrospectivo no qual foram avaliados 500 exames de tomografia computadorizada de abdome trifásico. As variações foram classificadas de acordo com Michels (1966) para a anatomia arterial e Cheng (1996) para a portal.

Resultados: Entre os casos estudados, 31,2% apresentaram variação quanto à vascularização arterial, sendo a mais prevalente a do Tipo V, com 8,2%. Nenhum participante foi identificado com o Tipo X, e 0,4% não puderam ser classificados. Com respeito à venosa, 21,8% eram variados, com maior prevalência do Tipo IV, observado em 8% das imagens analisadas.

Conclusões: Pode-se agregar conhecimento médico sobre as variações descritas e demonstrar sua prevalência na população estudada, o que é fundamental para o correto manejo das patologias cirúrgicas do abdome superior e para a redução das taxas de complicações pós-operatórias. Variações não classificadas por ensaios prévios devem ser categorizadas conforme sua importância clínica. Além disso, novos estudos devem ser encorajados a fim de compreender melhor os padrões populacionais do país e reduzir as taxas de mortalidade em procedimentos cirúrgicos relacionados aos vasos citados.

Palavras-chave

variação anatômica; circulação hepática; veia porta; artéria hepática; tomografia

Abstract

Background: Knowledge of the vascular anatomy of the liver and other abdominal organs helps surgeons improve preoperative planning, achieve greater surgical success, prevent complications, and reduce morbidity and mortality.

Objectives: To report the prevalence of anatomical variation in the proper hepatic artery and portal vein observed through computed tomography. Methods: This retrospective study was based on 500 3-phase abdominal computed tomography scans. Variations in arterial anatomy were classified according to the Michels system (1966), while those in regarding portal vein anatomy were classified according to the Cheng system (1996).

Results: A total of 31.2% of the cases showed variations in arterial vascularization, the most prevalent being type V (8.2%). No participants were identified with type X, and 0.4% could not be classified. A total of 21.8% showed variation in venous vascularization, with type IV being the most prevalent (8%).

Conclusions: Medical knowledge of these variations and their prevalence is fundamental for the correct surgical management of upper abdomen pathologies and lower rates of postoperative complications. Variations not classified by previous trials should be categorized according to their clinical importance, and new studies should clarify national population patterns to reduce mortality rates from surgical procedures that involve these vessels.

Keywords

anatomic variation; liver circulation; portal vein; hepatic artery; tomography

References

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Submitted date:
08/23/2024

Accepted date:
10/10/2024

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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