Territorial belonging of the middle hepatic vein in living liver donor candidates evaluated by three‐dimensional computed tomographic reconstruction and virtual liver resection
Territorial belonging of the middle hepatic vein in living liver donor candidates evaluated by three‐dimensional computed tomographic reconstruction and virtual liver resection
复制标题
通过三维计算机断层扫描重建和虚拟肝脏切除评估活体肝脏供体候选人的肝中静脉的领土归属
DOI：
10.1002/bjs.6444
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发表时间：
2009
影响因子：
9.6
通讯作者：
Lang H
中科院分区：
文献类型：
--
作者：
Radtke A;Sgourakis G;Sotiropoulos GC;Molmenti EP;Saner FH;Timm S;Malagó M;Lang H
在活体供肝移植中，术后静脉充血可导致移植物和残存肝功能衰竭。本研究旨在揭示肝中静脉(MHV)的“属地归属”，以明确肝静脉流出淤血的高危因素。方法对138例活体供肝肝移植受者的右(RHL)和左(LHL)半肝的MHV归属模式进行了三维CT重建和虚拟肝切除术。结果肝右静脉(RHV)占84.1%，副肝下静脉(IHV)占47.1%。RHL有三种MHV属型别。A型和C型强而复杂的MHV与较大的RHL静脉淤血相关。MHV属于LHL的比例为65.9%，耗尽了这个半球的37%。在虚拟肝切除术中，左MHV D型是左肝小残留物的风险类别。结论MHV属地A型和C型是RHL静脉充血的高危因素。他们的存在应促使考虑将MHV纳入适当的嫁接或重建其支流，并保护IHV领土。
BackgroundPostoperative venous congestion can lead to graft and remnant liver failure in living donor liver transplantation. This study was designed to delineate ‘territorial belonging’ of the middle hepatic vein (MHV) and to identify hepatic venous anatomy at high risk of outflow congestion.MethodsMHV belonging patterns for right (RHL) and left (LHL) hemilivers were evaluated by three-dimensional computed tomographic reconstruction and virtual hepatectomy in 138 consecutive living liver donor candidates.ResultsThe right hepatic vein (RHV) was dominant in 84·1 per cent and an accessory inferior hepatic vein (IHV) was present in 47·1 per cent of livers. Three MHV belonging types were identified for the RHL. Strong and complex MHV types A and C were associated with large RHL venous congestion. The MHV belonged to the LHL in 65·9 per cent, draining 37 per cent of this hemiliver. In virtual liver resections, left MHV type D was a risk category for small left liver remnants.ConclusionMHV territorial belonging types A and C were identified as high risk for RHL venous congestion. Their presence should prompt consideration of either inclusion of the MHV with the right graft or reconstruction of its tributaries, and preservation of IHV territory.
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影响因子：
25.7
作者：
Tanaka, K;Yamada, T
通讯作者：
Yamada, T
影响因子：
4.6
作者：
Valentín-Gamazo, C;Malagó, M;Broelsch, CE
通讯作者：
Broelsch, CE
右叶成人活体肝移植肝静脉流出道重建的技术挑战
影响因子：
4.6
作者：
R. Ghobrial;C. Hsieh;S. Lerner;S. Winters;N. Nissen;S. Dawson;F. Amersi;Pauline W. Chen;D. Farmer;H. Yersiz;R. Busuttil
通讯作者：
R. Busuttil
右肝移植活体肝移植中肝静脉重建的指征。
影响因子：
0.9
作者：
T. Kubota;S. Togo;H. Sekido;R. Shizawa;K. Takeda;D. Morioka;K. Tanaka;I. Endo;H. Shimada
通讯作者：
H. Shimada
计算机模拟右活体肝切除术中肝中静脉的分支模式和引流区域
影响因子：
8.8
作者：
J. Neumann;J. Neumann;M. Thorn;L. Fischer;Max Schöbinger;T. Heimann;B. Radeleff;Jan Schmidt;H. Meinzer;M. Büchler;P. Schemmer
通讯作者：
P. Schemmer