Anastomosis between the middle and right hepatic vein.
Anastomosis between the middle and right hepatic vein.
复制标题
中肝静脉和右肝静脉之间的吻合。
作者：
H. Sugimoto;T. Kaneko;A. Nakao
目前，没有肝中静脉的右肝移植物或有肝中静脉的左肝移植供者的残肝是否需要保留和重建肝中静脉支静脉，尚未得到证实。充血依赖于肝内相通的肝静脉。我们在此报告一位54岁的男性，他曾是活体肝移植的供体，并接受了包括肝中静脉在内的扩展左肝切除术。他的残余右肝叶由右肝静脉引流，因此肝切除术后肝前段可能充血。然而，它实际上并不拥挤。我们使用左肝移植肝中静脉，观察到残肝肝中静脉分支血流呈顺行双相波形，即“肝静脉波形的镜像”。我们认识到肝中静脉分支是一条有效的引流静脉。事实上，在这种情况下，不需要重建肝中静脉支流。“肝静脉波形镜像”是提示引流血流充足的重要标志。
Now, the need for preservation and reconstruction of the middle hepatic vein tributaries in the right liver graft without middle hepatic vein or in the remnant liver in the donor using left liver graft with middle hepatic vein has not been confirmed. Congestion depends on the intrahepatic communicating hepatic veins. We report herein the case of a 54-year-old man who had been the donor in a living-related liver transplantation and underwent extended left hepatectomy including the middle hepatic vein. His remnant right hepatic lobe was drained by the right hepatic vein, so the anterior segment was likely to be congested after hepatectomy. However, it had not been congested in fact. We observed blood flow with an antegrade biphasic waveform, which was "a mirror image of the hepatic venous waveform", in the branch of middle hepatic vein in the remnant liver using left liver graft with middle hepatic vein. We recognized that the branch of middle hepatic vein had functioned as an effective drainage vein. Indeed, reconstruction of the middle hepatic vein tributaries was not needed in this case. "The mirror image of hepatic venous waveform" is an important sign that indicates adequate drainage blood flow.