静脉韧带及肝圆韧带的解剖学观察

Anatomic observation of ligamentum venosum and ligamentum teres hepatis

目的 探讨门腔分流新途径。方法 选择成人正常肝脏４４ 例，解剖观测静脉韧带、肝圆韧带等。结果 静脉韧带走行于肝下面的静脉韧带裂内，连于门静脉左支和下腔静脉之间，长约４ ．０９ ±０．６１ｃｍ ； 肝圆韧带连于脐和门静脉左支之间， 其肝外段和肝内段分别长约１４．５１±３．４４ ｃｍ ，５．７５±０ ．９９ｃｍ 。静脉韧带和肝圆韧带内均有间断残腔存在，且以近心段最为明显，分别长达１．９９ ±０ ．３９ｃｍ和２ ．９１ ±０．６２ｃｍ 。肝圆韧带和静脉韧带均可用２ｍ ｍ 的铁丝使其再通。结论 于脐处切口，扩张再通肝圆韧带、静脉韧带至下腔静脉，实现门腔分流通道具有可行性。

Objective To explore the new path of porto-systemic shunt. Methods Forty four normal adult livers were chosen; ligamentum venosum and ligamentum teres hepatis were anatomized, observed and measured. Results The ligamentum venosum lie in the fissure for ligamentum venosum, connected between the left branch of portal vein and inferior vena cava,and about 4.09±0.61cm in length .The ligamentum teres hepatis links between umbilicus and left branch of portal vein, and its inner and outer segments of liver are 14.51±3.44cm and 5.75±0.99cm in length respectively. There are residual cavity both in ligamentum venousumand ligamentum teres hepatis, especially their segments near the heart, 1.99±0.39cm and 2.91±0.62cm in length individual. The ligamentum venousum; ligamentum teres hepatis can be repassed with iron wire with 2mm in diameter.Conclusion If an incision is made at umbilical part, expanding and repassing ligamentum teres hepatis and ligamentum venousum to inferior vena cava,it is possible to establish the canal for porto-systemic shunt.