Cawich SO, Thomas DA, Mohammed F, Gardner MT, Craigie M, Johnson S, Kedambady RS. Hepatic grooves: An observational study at laparoscopic surgery. World J Exp Med 2024; 14(2): 94357 [PMID: 38948419 DOI: 10.5493/wjem.v14.i2.94357]
Corresponding Author of This Article
Shamir O Cawich, FACS, Professor, Department of Surgery, University of the West Indies, St Augustine Campus, St Augustine 000000, Trinidad and Tobago.socawich@hotmail.com
Research Domain of This Article
Anatomy & Morphology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Exp Med. Jun 20, 2024; 14(2): 94357 Published online Jun 20, 2024. doi: 10.5493/wjem.v14.i2.94357
Hepatic grooves: An observational study at laparoscopic surgery
Shamir O Cawich, Dexter A Thomas, Fawwaz Mohammed, Michael T Gardner, Marlene Craigie, Shaneeta Johnson, Ramnanand S Kedambady
Shamir O Cawich, Fawwaz Mohammed, Department of Surgery, University of the West Indies, St Augustine 000000, Trinidad and Tobago
Dexter A Thomas, Department of Surgery, Port of Spain General Hospital, Port of Spain 000000, Trinidad and Tobago
Michael T Gardner, Section of Anatomy, Basic Medical Sciences, University of the West Indies, Kingston 000000, Jamaica
Marlene Craigie, Department of Radiology, University of the West Indies, Kingston 000000, Jamaica
Shaneeta Johnson, Department of Surgery, Morehouse School of Medicine, Atlanta, GA 30310, United States
Ramnanand S Kedambady, Section of Anatomy, Department of Basic Medical Sciences, University of the West Indies, Kingston KIN7, Jamaica
Author contributions: Cawich SO, Gardner MT, Kedambady RS, Craigie M, Thomas D, Mohammed F and Johnson S designed the research; Cawich SO, Gardner MT and Kedambady RS, performed the research; Kedambady RS, Mohammed F and Johnson S contributed analytic tools; Kedambady RS, Thomas D and Johnson S analyzed the data; Cawich SO, Gardner MT, Kedambady RS, Craigie M and Thomas D wrote the paper; All authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the University of the West Indies' Institutional Review Board, Approval No. CREC.SA.1034.06.2021.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The authors are willing to share any relevant data upon reasonable request to the corresponding author at socawich@hotmail.com.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement and checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shamir O Cawich, FACS, Professor, Department of Surgery, University of the West Indies, St Augustine Campus, St Augustine 000000, Trinidad and Tobago.socawich@hotmail.com
Received: March 17, 2024 Revised: April 22, 2024 Accepted: May 6, 2024 Published online: June 20, 2024 Processing time: 94 Days and 9.4 Hours
Abstract
BACKGROUND
In traditional descriptions, the upper surface of the liver is smooth and convex, but deep depressions are variants that are present in 5%-40% of patients. We sought to determine the relationship between surface depressions and the diaphragm.
AIM
To use exploratory laparoscopy to determine the relationship between surface depressions and the diaphragm.
METHODS
An observational study was performed in all patients undergoing laparoscopic upper gastro-intestinal operations between January 1, 2023 and January 20, 2024. A thirty-degree laparoscope was used to inspect the liver and diaphragm. When surface depressions were present, we recorded patient demographics, presence of diaphragmatic bands, rib protrusions and/or any other source of compression during inspection.
RESULTS
Of 394 patients, 343 had normal surface anatomy, and 51 (12.9%) had prominent surface depressions on the liver. There was no significant relationship between the presence of surface depressions and gender nor the presence of rib projections. However, there was significant association between the presence of surface depressions and diaphragmatic muscular bands (P < 0.001).
CONCLUSION
With these data, the diaphragmatic-band theory has gained increased importance over other theories for surface depressions. Further studies are warranted using cross sectional imaging to confirm relationships with intersectional planes as well as beta-catenin assays in the affected liver parenchyma.
Core Tip: The upper surface of the liver is usually smooth and convex, but deep depressions are present in 5%-40% of patients. Laparoscopic surgery provides an opportunity to examine the relationship between surface depressions and the diaphragm. This study showed that 51 (12.9%) of 394 patients had prominent surface depressions on the liver. There was significant association between the presence of surface depressions and diaphragmatic muscular bands, giving credence to the diaphragmatic-band theory for surface depressions.
