重视“门短静脉”解剖在围肝门手术中的意义

Emphasis on the significance of "short hepatic portal vein" anatomy in perihepatic portal surgery

围肝门区域是以门静脉主干与左、右分支汇合部为中心、界于肝脏脏面"H形横沟"范围内的解剖区域。其解剖结构复杂,涉及肝脏、胆囊、区域淋巴结等器官、组织和门静脉、肝动脉、胆管及下腔静脉等脉管系统,是肝胆外科手术的难点区域,合理的手术入路至关重要。运用"Glisson鞘内游离"的解剖入路策略,能够清晰展现围肝门区域各脉管系统的解剖结构,降低手术误损伤风险,有助于合理的个体化手术方案决策及实施。门短静脉是存在于门静脉主干、右支和左支及其汇合部的细小分支,分布、走行于肝脏横沟区域内。实施围肝门区域"Glisson鞘内游离",不应忽视门短静脉的解剖学特点。

Perihilar area is a clinically specific anatomical area centered on the confluence of the main portal vein with the left and right branches and bounded by the 'H-shaped transverse sulcus' of the liver. Its anatomical structure is complex, involving the liver, gallbladder, regional lymph nodes and luminal systems such as portal vein, hepatic artery, bile duct and inferior vena cava. It is a difficult area in hepatobiliary surgery. Therefore, a reasonable surgical approach is of great importance. The anatomical approach strategy of 'Glisson intrathecal dissociation' can clearly show the anatomical structure of various luminal systems in the perihilar area, reduce the risk of surgical error injury, and contribute to the rational individualized surgical plan decision and implementation. The short hepatic portal vein is a small branch of the main, right and left branches of the portal vein and their confluence, which distributes and travels in the transverse sulcus of the liver. The anatomical characteristics of the short hepatic portal vein should not be ignored in the implementation of 'Glisson intrathecal dissociation' in the perihilar area.