ANATOMY OF THE PORTAL-VEIN BIFURCATION - INTRAHEPATIC VERSUS EXTRAHEPATIC LOCATION - IMPLICATIONS FOR TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNTS

PURPOSE: To delineate the relationship of the main portal vein bifurcation to the liver capsule, an anatomic study of the portal vein bifurcation was undertaken in 31 cadavers. MATERIALS AND METHODS: The portal bifurcation was characterized as intrahepatic, extrahepatic, or at the liver capsule (junctional). When the bifurcation was extrahepatic, the exposed portions of the right and left portal veins were measured. RESULTS: The portal bifurcation was intrahepatic in eight cadavers (25.8%), at the liver capsule in eight cadavers (25.8%), and extrahepatic in 15 cadavers (48.4%). The maximum lengths of exposed extrahepatic right and left portal veins were 3.0 cm and 2.5 cm, respectively. CONCLUSION: These findings suggest that for transjugular intrahepatic portosystemic shunt placement, a portal vein puncture site 3 cm from the portal bifurcation will be intrahepatic in most cases.