肝右后叶Glisson鞘的应用解剖学研究

An applied anatomical study of the right posterior sectional Glissonean pedicle

目的观察肝右后叶Glisson鞘的解剖结构及走行分布情况，为实施右后叶精准肝切除术提供解剖学基础。方法通过20例成人无病变尸体肝脏的剥离解剖，对肝右后叶Glisson鞘进行形态学观察，采集相关数据并进行统计学分析。结果右后支Glisson鞘存在共干和无共干的分别占95％和5％，G右后／G右前的夹角为（81．4±13．8）°；30％的右后支Glisson鞘呈Y型与V型，Y型中G6／G7的夹角为（71±3．92）°；70％右后支Glisson鞘主干呈C型，辐射状三级分支数目为3—8支不等。结论右后叶Glisson鞘走行分布情况并不完全符合Couinaud分段的描述，且存在明显的个体差异。在实施精准肝切除术之前了解右后叶Glisson鞘的解剖，有助于降低手术风险，减少术后并发症。

Objective To study the anatomical structure and the distribution of the right posterior sectional Glissonean pedicle so as to provide the anatomical basis for liver resection of the right posterior section. Method By studying the morphological features of the right posterior sectional Glissonean pedicle through peeling and dissecting 20 adult corpses without liver pathological. Result In 95 % of the right posterior sectional Glissonean pedicles there were shared branches. The angle between the GRL/GRA was 81.4° ± 13.8°. In 30%, the right posterior sectional Glissonean pedicle presented as a Y or a V. In a Y shaped, the angle between G6/G7 was 71 ° ± 3.92°. The shapes of 70% of the right posterior sectional Glissonean pedicle presented as a C. The number of branches at the tertiary level was between 3-8. Conclusion The distribution of the right posterior sectional of the Glissonean pedicle did not entirely fit the description of Couinaud＇s segments. Obvious individual differences existed. Under this circumstance, understanding the anatomy of the right posterior sectional Glissonean pedicle before carrying out partial hepatectomy would be helpful in reducing surgical risks and postoperative complications.