肝脏尾状叶肿瘤切除技术探讨

Discussion on the technique of resection of liver tumor in the caudate lobe

肝尾状叶解剖学上分Spiegel部、下腔静脉旁部及尾状突三部分,位于肝脏背侧,紧邻下腔静脉、三支肝静脉及门静脉左右支。尾状叶定位依赖于解剖标志定位及染色定位,特别是反染技术。尾状叶手术左侧径路适合于Spiegel部切除,右侧径路适合下腔静脉旁部及尾状突切除,背侧径路、前侧径路结合其他径路可以达到完整切除尾状叶目的。本文介绍了多径路联合全尾状叶肿瘤切除、部分尾状叶切除及腹腔镜尾状叶切除。

The caudate lobe of liver is anatomically divided into three parts:Spiegel portion,inferior vena cava portion and caudate process.The caudate lobe of the liver is located in the dorsal side of the liver,adjacent to the inferior vena cava,the three hepatic veins,and the left and right portal veins.The location of the caudate lobe depends on the location of anatomical landmarks and the location of staining,especially negative staining techniques.The left approach is suitable for Spiegel resection,and the right approach is suitable for paracentral resection of the inferior vena cava and caudate process.The dorsal approach and anterior approach combined with other approaches can achieve complete caudate resection.This article showed the combination of multimodal approach with total caudate lobectomy,partial caudate lobectomy and laparoscopic caudate lobectomy.