Venous blood of the liver is drained by
a. The majority of the venous drainage of the liver occurs through three hepatic veins.
b. The right hepatic vein drains segments V, VI, VII, and VIII, and enters directly into the vena cava.
c. The middle hepatic vein drains segments IVA, IVB, V, and VIII, and enters into a common orifice with the left hepatic vein that drains segments II and III.
d. A scissural branch of the left hepatic vein may run underneath the falciform ligament.
e. A number of small short hepatic veins enter directly into the vena cava from the undersurface of the liver in segment I.
f. Direct venous drainage into the vena cava is through small, short hepatic veins, although large segmental branches may also be present and are usually seen on high-quality preoperative imaging studies.
g. Major middle vein tributaries from segments V and VIII also can be detected by CT scan, and noting the location of such structures with intraoperative ultrasound can help avoid unnecessary blood loss during liver resection.