改良犬原位背驮式肝移植的解剖学观察

Anatomical research of canine liver for a modified orthotopic piggyback liver transplantation model

目的观察犬肝脏解剖学特点,探索建立改良的犬同种异体原位背驮式肝移植模型.方法对15只杂交犬的肝脏进行活体和尸体标本的解剖观察.结果犬肝共分7叶,门静脉分左右支进入肝脏,门静脉左支供应约70%肝组织(Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ叶),门静脉右支供应约30%肝组织(Ⅵ、Ⅶ叶),分别阻断门静脉左、右支后5 min左右门静脉压力达到峰值,并迅速回复至门静脉正常压力值上限范围内;肝动脉和胆管与门静脉分支伴行进入各肝叶;左肝静脉粗大,可以作为肝静脉重建的流出道,其余3～6支肝静脉可以分别结扎,肝后下腔静脉易于与肝脏分离.结论犬肝的解剖学特点适宜于建立改良的原位背驮式肝移植模型.

Objective To investigate the anatomical features of canine liver and study whether a modified orthotopic piggyback liver transplantation can be established in canines. Methods Fifteen liver specimens were observed in living and cadaver canines. Results The liver has seven lobes. The portal vein terminated in the porta hepatic by bifurcating into right and left branches, which cavered the anatomic right parts （Ⅵ and Ⅶ. representing 30% of the total liver） and left parts, respectively （ Ⅰ , Ⅱ ,Ⅲ ,Ⅳ and Ⅴ, representing approximately 70% of the total liver）. Portal vein pressure reached peak level within 5 min and then descend to normal range after blockage of left or right branch of portal vein respectively. Hepatic artery and biliary ducts distributed correspondingly with portal vein branch. Left hepatic vein was thick that could be used to rebuild outflow tract of the newly trans planted liver. The other hepatic veins could be ligated, and thus the total liver could be removed with preservation of the posthepatic inferior caval vein. Conclusions it is suggested that a modified piggyback liver transplantation can be established in caines.