Surgical Anatomy of Liver Vessels

Abstract

The work "Surgical Anatomy of Liver Vessels" highlights the variability of the shape and position of the liver and gallbladder, as well as the features of branching and the relationship between the portal and hepatic veins. Depending on the branching of the intraorgan vessels, the liver is divided into segments.

The work suggests original incisions of the liver, designed in terms of preventing bleeding, as well as maintaining normal blood circulation in the liver.

Liver surgery, which is so successful in the world today, is based on research that was mainly developed in the 1920s-1950s, and on the basis of which it became possible to perform bloodless (or with minimal blood loss) liver resection. The undisputed leader among the authors of this type of research is the French anatomist and surgeon Claude Couinaud, whose research results are recognized as a guideline in liver surgery. However, Professor Shamshe Kevanishvili is also a worthy representative of that small group of researchers for whom it was equally important to prevent bleeding during liver resection and to maintain a complete blood supply to the remaining part after resection. Taking into account the above, the original rates provided by Professor Kevanishvili are especially important when performing so-called atypical liver resections. In this regard, the presented monograph has not lost its importance and fully retains its relevance.

In addition to the above, the additional portal veins and collateral pathways of the portal vein described by Professor Kevanishvili are still considered to be original contributions to the description of the hepatic vasculature.

Also, a very important fact is confirmed in the monograph that the gallbladder veins establish a connection between the left and right branches of the portal vein and such an anatomical feature may contribute to the metastasis of the tumor from one lobe of the liver to another. This discovery was the basis for the liver resection rule (in case of tumor damage to the organ) proposed by Professor Merab Sareli (Izraelashvili), one of the famous students of Professors Sh. Toidze and Sh. Kevanishvili. It involves prophylactic excision of the gallbladder in order to prevent the spread of metastases.

The presented English translation of the work popularizes the ideas and work of the Georgian scientist, and makes clear to foreign researchers the rich methodological possibilities of research (anatomical dissection, preparation of corrosive specimen, X-ray vasography, dissection under a binocular microscope, etc.) which were actively implemented and used by Georgian morphologists at that time.

The work is of interest to both morphologists and surgeons. It includes 44 illustrations and 9 tables.

The author of the translation is Gigi Gorgadze, a student of the single-level educational program of medical doctor at Tbilisi State Medical University. The translation was edited by Tamar Turmanidze, Associate Professor of Clinical Anatomy and Operative Surgery Department of TSMU.

Reviewers: Leading Specialist of the Sheba Medical Center - Israel, Foreign Member of the Georgian National Academy of Sciences, Doctor of Medical Sciences, Professor Merab Sareli (Izraelashvili) and Director of TSU Alexander Natishvili Institute of Morphology, Doctor of Medical Sciences, Professor Dimitri Kordzaia.