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Liver retreival

When the liver is cooled, it is mobilised by division of the triangular ligaments. The upper IVC is mobilised. The common bile duct is divided. The portal vein is divided. If the pancreas is to be taken then the portal vein is divided in its mid point otherwise it is taken lower down, often at the junction of the superior mesenteric and splenic veins. The common hepatic artery is identified and dissected down to the aorta, dividing alot of nerve tissue (coeliac plexus). An aortic patch of the coeliac axis is taken. Care must be taken to look out for abberent arterial anatomy. In particular the right hepatic artery may arise from the superior mesenteric system and the left may arise from the left gastric artery. It is best to take an aortic patch including the origins of both the coeliac axis and superior mesenteric artery. If there is an abberant right hepatic artery originating from the superior mesenteric artery then the abberant artery often passes through the pancreas so care must be taken in this situation not to damage the pancreas. The inferior IVC below the liver is now isolated and divided, care being taken not to damage the right renal vein. The bile ducts are washed out and the liver stored and transported.


next up previous index
Next: Pancreatic retreival Up: Multi organ retrieval Previous: Heart and lung retreival   Index
Adrian P. Ireland 2004-02-17