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. 2016 Oct-Dec;6(4):237-240.
doi: 10.4103/2229-516X.192588.

The "Triple-Q Algorithm:" A practical approach to the identification of liver topography

Omar Bekdache  1 , Ahmad Zarour  2 , Ayman El-Menyar  3 , Yassir Abdulrahman  4 , Husham Abdelrahman  4 , Mohammad Ellabib  4 , Ruben Peralta  4 , Hassan Al-Thani  4
Affiliations

The "Triple-Q Algorithm:" A practical approach to the identification of liver topography

Omar Bekdache et al. Int J Appl Basic Med Res. 2016 Oct-Dec.

Abstract

The descriptive identification and interpretation of liver pathology continue to raise debate, especially for trainees and junior physicians. There is wide diversity in the description of liver segmentation with sometimes contradictory terminology between French and American literature. Attempts were made to create a unified nomenclature that simplifies the problem. We propose a simple approach to describe the location of liver pathology in different settings by referring to an algorithm based on three questions. Explanations to answer these questions and correctly describe the location of liver pathology are herein described. In conclusion, we think that the adoption of such an algorithm called arbitrary "the Triple-Q Algorithm" will facilitate the understanding of liver topography for the young physicians, as well as it will allow for the accurate description and localization of the pathological lesions in the liver. This could be achieved after testing and validating this algorism in prospective studies. This could have academic and clinical implications in the medical education and the patient care.

Keywords: Hepatic topography; liver segmentation; nomenclature of liver anatomy.

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Figures

Figure 1
Figure 1
Liver configuration shows as a reversed flattened L-shape. IVC: Inferior vena cava, RHV: Right hepatic vein, MHV: Middle hepatic vein, LHV: Left hepatic vein, PV: Portal vein, RPV: Right portal vein, LPV: Left portal vein
Figure 2
Figure 2
The “triple-Q Algorithm”. IVC: Inferior vena cava. RHV: Right hepatic vein. MHV: Middle hepatic vein. LHV: Left hepatic vein, PV: Portal vein, GB: Gallbladder, FL: Falciform ligament, HV: Hepatic vein
Figure 3
Figure 3
(a) True division of the liver through Cantlie's line passing through the middle hepatic vein (black arrow). (b) Hepatic veins trifurcation. (c) Accessory right inferior hepatic vein (black arrow). MHV: Middle hepatic vein, LT: Left, RT: Right, IVC: Inferior vena cava
Figure 4
Figure 4
(a) Superior segments (II, IVA, VIII, VII) shown on the left side and inferior segments (III, IVB, V, VI) on the right side. Note the appearance of a part of the caudate lobe (segment I) in the anteromedial pericaval area. (b) Location of the caudate lobe or segment I of the liver between the inferior vena cava and the portal vein
See this image and copyright information in PMC

References

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