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Abstract

Understanding anatomical variations of accessory right hepatic veins (aRHVs) is crucial in hepatobiliary and liver transplantation (LT) surgeries. During these procedures, multiple small accessory veins between the liver and the inferior vena cava (IVC) may be encountered, which are often missed on CT scans and might not be true aRHVs. True aRHVs include the inferior right hepatic vein (IRHV), which drains segment VI directly into the IVC, and the middle right hepatic vein (MRHV), which drains segment VII (Figure 1). Their occurrence, shape, and number vary significantly, with reported rates ranging from 6% to 52.5%. The simultaneous presence of MRHV and IRHV is extremely rare. Computed tomography (CT) remains the primary method for preoperative detection, enabling accurate vascular mapping and reducing surgical risks.