肝左三角韧带及其游离缘的形态和结构

FORM AND STRUCTURE OF LIGAMENTUM TRIANGULARE SINISTRUM HEPATIS AND ITS FIBROUS APPENDIX

本文对42例成年男性尸体的肝左三角韧带及其游离缘,进行了观察测量,并对共中37例的游离缘作了组织学观察;此外,还对30例新生儿的肝左三角韧带,做了对照观察。42例成人肝左三角韧带的平均长度为13.91cm,其游离缘的平均长度为6.86cm;肝左三角韧带全长位于肝左叶上面者占97.5%,将左肝上间隙分为前、后两个间隙。42例成人的肝左三角韧带均有游离缘,其形态可分为5种类型;30例新生儿的肝左三角韧带均无游离缘。对37例成人肝左三角韧带游离缘的组织学观察,发现其内有残余肝细胞索者达65%,有胆管者达89%,有血管者达100%,有神经者达78%;残余肝细胞索、神经和胆管的出现,都由近侧向远侧逐渐减少。肝左三角韧带游离缘可能是生后肝左叶退缩遗留下来的结构。

The left triangular ligament of liver and its fibrous appendix(free border)was studied in 42 Chinese adult male cadavers.37 fibrous appendices were further studied histologically.In order to prove the formation of the fibrous appendix 30 left triangular ligaments of new born cadavers were also studied.The average length of the left triangular ligament of adult cadavers was 13.91cm.,and that of their fibrous appendices was 6.86cm.Almost all of the left triangular ligaments were attached to the superior surface of the left lobe of liver,consequ-ently,the left suprahepatic space could be properly subdivided into anterior and posterior left suprahepatic spaces by the ligament.The forms of the fibrous appendices were classified into 5 types:triangular(23.8%),narrow band(14.3%),triangular-narrow band(50.0%),membranous(7.1%),and bifurcate type(4.8%).The left triangular ligaments of the 30 new born cadavers were devoid of fibrous appendix.Histological observations of the 37 fibrous appendices showed:aberrant bile ducts were found in 89%of the cases,rudimentory liver-cell cord 65%,nerves 78%,and blood vessels 100%.Their size and number diminished gradually from the pro-Kimal(hepatic)end of the fibrous appendix to the distalend.The authors agreed with Toldt and Zuckandl that the fibrous appendix might be the result of the retrogression of the left lobe and suggested that the occurrence of the fibrous appendix was after birth.The clinical importance of the fibrous appen-dix was discussed.