Accessory right inferior hepatic vein

Last revised by Mostafa Elfeky on 6 Sep 2023

An accessory right inferior hepatic vein is the most common variation of the hepatic veins, and may be multiple 1. It is present in up to 48% of the population and drains the posteroinferior part of the right lobe directly into the inferior vena cava (IVC) 1-3.

Variations in hepatic vascular anatomy are particularly important in the setting of liver surgery, transplantation, and interventional radiology. An accessory right inferior hepatic vein can account for up to 11% of venous drainage of the liver, risking excessive bleeding and compromised venous drainage of a liver graft if unrecognised 1,4.

An accessory right inferior hepatic vein can help to drain liver segments 6 that remain following bisegmentectomy 7-8 (right superior liver resection) 5.

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