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https://doi.org/10.14300/mnnc.2022.17090

The variability in clinical anatomy of the umbilic vein depending on the somatotype and optimization of transumbilical access to the portal vein system

[Original research] [Surgery]
Boris Mikhailovich Belik; Ahmed Sapraliev; Sergei Efanov; Vladislav A. Suyarko; Dmitry Vladimirovich Mareev; Mikhail Arkadyevich Oskanyan;

The aim of the study was to detect the variability of the umbilical vein clinical anatomy (UV) depending on the somatotype and to optimize the technology of transumbilical catheterization of the portal vein system. Anatomical studies were performed using sectional material in situ and by studying the liver preparations from 108 male corpses of various constitutions. It was found that the position of the liver in the abdominal cavity and the angioarchitectonics of the portal system largely depend on the somatotype, which significantly affects the surgical technique of bougienage of the UV. In persons of a dolicomorphic and partially mesomorphic constitution, the liver is most often located ventropetally, there is a shortening of the UV length and a decrease in its diameter. Here is an insufficiently developed angle of entry of v.umbilicalis into the left branch of the portal vein, which creates certain difficulties in the bougienage of the vien. To overcome these difficulties, a special set of bougie with different bending angles was used, which corresponded to the angle of inflow of the UV into the left branch of the portal vein in individuals with different body types. Transumbilical catheterization of the portal vein system according to the developed technique was successfully applied in the clinic in the treatment of 59 patients with abdominal surgical infections.

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Keywords: umbilical vein, portal vein system, body types, variability of clinical anatomy, bougienage and catheterization of the umbilical vein