 Welcome to the third part of our discussion of the abdominal viscera and Dr. Sanjay Sanyal, Professor and Department Chair of Anatomical Sciences. I have dissected all the structures in the portahepatis in much more detail and you will see some very interesting things. So let's first quickly identify what are the structures in the portahepatis that we had seen till now. Since normally they are very close together, they are enclosed in a peritoneum fold called the hepatoturnal ligament but I have dissected them out and separated them out so they are very far away now. So this is the bile duct, this is the hepatic artery, this is the portal vein. Let's take a look at them one by one and we will see some very interesting things. Let's take a look at the bile duct first. As I told you in my last dissection that this was a biped gallbladder and you can see that this is a biped gallbladder. That means it has got two lobes, bilobed or biped. But this has got only one cystic duct. The one cystic duct here and this cystic duct is continuing down and it's opening into the common hepatic duct which is here and it is forming the common bile duct. And the common bile duct is then running behind the diodenum, it is running behind the superior part of the diodenum and it is then opening in the second part of the diodenum along with the pancreatic duct through the hepato-pancreatic ampulla. So we are looking at the posterior aspect of the pancreatic ampulla and the diodenum to show you the full course of the common bile duct. We notice that the cystic duct is very long and this is the callot strangle I was talking about. Okay, let's trace the common hepatic duct up towards the portahepatus. This is the common hepatic duct and we can see that the common hepatic duct is dividing into a right hepatic duct here and a left hepatic duct here. In this particular case the right hepatic duct is smaller than the left hepatic duct but these are the two hepatic ducts and they have formed the common hepatic duct meeting with the cystic duct to form the common bile duct. So this is the callot strangle, this is the callot strangle, are we clear? Okay, what was the important content of the callot strangle? And you can see the cystic artery here. There's one cystic artery which is coming from the hepatic artery. It should, we have studied that this right hepatic artery gives us, but here it is the hepatic artery proper which is giving rise to the cystic artery. And then the hepatic artery is continuing up and it is dividing into a right and a left branch. It is dividing further up in the portahepatus. It is dividing into a right hepatic artery and it's dividing into a left hepatic artery. So therefore there are a few variations here. So this is the hepatic artery. How do we know this is the hepatic artery? Because I told you, this is the hepatic artery, this is the gastrodeodontal artery, this is the hepatic artery, common hepatic artery and we can trace it all the way to the celiac trunk here. So we know that this is the hepatic artery. Okay, now let's come to the third part of the portotriad in the portahepatus. This was our hepatic in the portal vein. If you see, if you trace it in the portahepatus, you find that it is again dividing into two major divisions. You can see one major division here. This is the right branch of the portal vein and this is the left branch of the portal vein. Let's trace the portal vein in the reverse direction. For that I'll just turn this and we can see that this is the portal vein. This is the superior miscentric vein and you can see, if I put a probe here it will go into this. This is the superior miscentric vein. It is meeting with the splenic vein which is running behind the pancreas. I have decided it out all the way to the spleen. This is the spleenic vein. It is running below the hepatic artery. This is the spleenic vein. It is meeting with the superior miscentric vein and it is forming the portal vein. While I am on this topic, if I were to put the spleen in its normal location, you will find that the spleenic vein is located quite close to the left renal vein. Therefore, we can do a splenorenal shunt. That is what is done in portal hypertension. There are two types of splenorenal shunt. One is where we retain the spleen and we anastomose this end. The other is when we remove the spleen and anastomose this end. One is called distal splenorenal shunt. One is called proximus splenorenal shunt. I have removed the inferior miscentric vein, which is running with the inferior miscentric artery. This was the inferior miscentric artery and this was the inferior miscentric vein, which was opening into the spleenic vein. These are the structures and these are the salient points I wanted to show you in more detail in the portahepatus. Thank you very much for watching, ladies and gentlemen. Have a nice day.