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 bifurca tion to the liver capsule, an anatomic study of the portal vein bifurc ation was undertaken in 31 cadavers. MATERIALS AND METHODS: The portal bifurcation was characterized as intrahepatic, extrahepatic, or at th e liver capsule (junctional). When the bifurcation was extrahepatic, t he 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 r ight and left portal veins were 3.0 cm and 2.5 cm, respectively. CONCL USION: These findings suggest that for transjugular intrahepatic porto systemic shunt placement, a portal vein puncture site 3 cm from the po rtal bifurcation will be intrahepatic in most cases.