肝硬化肝脏肝门板和肝静脉的解剖及其临床应用

Hilar plate and hepatic vein in cirrhosis: Anatomy and clinical application

目的 探讨选择性区域无血肝切除的应用解剖。 方法 对 5例肝炎后肝硬化新鲜离体肝脏进行肝门板和肝静脉的解剖测量。 结果 5例肝硬化肝脏的肝门板左主干平均宽 1 78cm、深 0 82cm ;左内叶支平均宽 1 0 4cm、深 1 0 2cm ;左外上支平均宽 0 96cm、深 0 74cm ;左外下支平均宽 1 0 2cm、深 0 76cm ;右主干平均宽 2 0 2cm、深 1 2 8cm ;右后叶支平均宽1 2 0cm、深 1 1 0cm ;右前叶支平均宽 1 2 2cm、深 1 1 6cm。肝左静脉平均宽 0 82cm、深 0 74cm ;肝右静脉平均宽 1 1 6cm、深1 0 4cm ;肝中静脉平均宽 0 92cm、深 1 1 8cm。临床成功应用 2例区域无血肝切除。 结论 选择性阻断病灶所在出入肝叶或肝段的血流 。

Objective To study the application of the selective regional anemia hepatectomy. Methods The hepatic veins and hilar plates of 5 liver samples of posthepatitic cirrhosis were measured. Results Out of the 5 samples, the average width and depth of the left branch of hilar plate were 1.78cm and 0.82cm, of the left medial branch were 1.04cm and 1.02cm, of the left lateral superior branch were 0.96cm and 0.74cm, of the left lateral inferior branch were 1.02cm and 0.76cm, of the right branch were 2.02 cm and 1.28cm, of the right posterior branch were 1.20cm and 1.10cm, and of the right anterior branch, 1.22cm and 1.16cm. The average width and depth of the left hepatic vein were 0.82cm and 0.74cm, of the right hepatic vein were 1.16cm and 1.04cm, and of the middle hepatic vein, 0.92cm and 1.18cm. The regional anemia hepatectomy was performed successfully in 2 cases. Conclusions Selective occlusion of the blood flow in and out the hepatic segment or lobe may contribute to a safe and reliable hepatectomy.