Couinaud's liver segmentation is based on which anatomical structures to define segment boundaries?

• A Portal vein branches only
• B Hepatic veins (inter-segmental planes) and portal pedicles (intra-segmental supply) ✓
• C Hepatic artery branches and bile ducts
• D Hepatic veins and the falciform ligament

Explanation

Couinaud's segmentation divides the liver into 8 independent functional units based on hepatic venous drainage (which form the inter-segmental planes — scissurae) and portal pedicle supply (which defines the territory of each segment). Each segment has its own portal triad (portal vein, hepatic artery, bile duct) and drains independently into a hepatic vein, allowing safe anatomical resection. The falciform ligament overlies the umbilical fissure separating segments II/III from IV.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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