Single hepatic vein, anatomical risk variant for hepatectomy

A 52-year-old woman with a history of left colectomy due to T3N1M1 adenocarcinoma, presented a liver lesion in segment IV that restricted diffusion (Fig. 1A and B), with the presence of a single suprahepatic vein (Fig. 1C–E). We performed left hepatectomy extended to segment VIII (histology: colorectal metastasis) due to left portal involvement and confirmed the anatomical variant intraoperatively, which required careful ultrasound-guided liver dissection. A postoperative CT scan confirmed the preservation of the hepatic venous drainage (Fig. 1F).

Figure 1

The single suprahepatic vein is exceptionally rare. However, knowledge of it, a meticulous surgical technique and radiological reconstruction are essential to avoid iatrogenesis.

Acknowledgements

The authors would like to acknowledge the General and Digestive Surgery Service as well as the Abdominal Organ Transplantation Service of the Hospital Universitario 12 de Octubre.