The lesser omentum is a double fold of peritoneum running from the liver to the lesser curvature of the stomach and the start of the duodenum. It has two parts, the hepatogastric and hepatoduodenal ligaments, and its free right edge carries the portal vein, hepatic artery and bile duct. It forms part of the front wall of the lesser sac.
| Origin | Porta hepatis and fissure for the ligamentum venosum of the liver |
|---|---|
| Insertion | Lesser curvature of the stomach and first 2 cm of the duodenum |
Double fold of peritoneum that holds the stomach to the liver and carries the portal vein, hepatic artery and bile duct in its free right edge.
The lesser omental free edge is the site of the Pringle manoeuvre. Digital compression of the hepatoduodenal ligament to control hepatic inflow during liver surgery. Portal hypertension distends the portal vein within the lesser omental free edge. In liver transplantation, the hepatoduodenal structures within the lesser omental free edge are anastomosed in sequence. Cholangiocarcinoma at the hepatic hilum involves the lesser omental contents.
Digital or clamp compression of the lesser omental free edge containing the portal triad to reduce hepatic inflow during liver surgery, safe for up to 60 minutes of ischaemia in a non-cirrhotic liver.
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