肝内门—腔静脉内支架吻合分流术（TIPSS）的应用解剖学

Applied anatomic study for transjugular intrahepatic portosystemic stent shunt(TIPSS)

在４３例肝脏标本上从肝脏面解剖出肝静脉、门静脉、肝管和肝动脉，观测了肝静脉的汇合类型、肝静脉与门静脉相交部位口径、两静脉间距和至第二肝门的距离。结合ＴＩＰＳＳ术进行了讨论，作者认为由肝静脉穿刺门静脉行吻合分流的首选部位是在肝右静脉与门静脉右支及其分支之间；其次在肝中静脉与门静脉左支之间，而肝左静脉与门静脉左支之间吻合较难达到分流目的。

isceral surface of the liver was dissected to expose the hepatic vein,the portal vein,the hep-atic duct and the hepatic artery on 43 adult liver specimens. The types of convergence,calibres andbetween the hepatic and portal veiiis were observed.The first selected place for TIPSS is betweenthe right hepatic vein and the right trunk of portal vein; and the second place is between the mid-dle hepatic vein and the left trunk of the portal vein. It would be difficult to achive TIPSS by anas-tomosing the left trunk of portal vein with the hepatic vein.