Reconfirmation of the anatomy of the left triangular ligament and the appendix fibrosa hepatis in human livers, and its implication in abdominal surgery
Reconfirmation of the anatomy of the left triangular ligament and the appendix fibrosa hepatis in human livers, and its implication in abdominal surgery
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DOI：
10.1002/jhbp.144
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发表时间：
2014-12-01
影响因子：
3
通讯作者：
Makuuchi, Masatoshi
中科院分区：
文献类型：
--
作者：
Kogure, Kimitaka;Kojima, Itaru;Makuuchi, Masatoshi
背景本研究的目的是阐明左三角韧带（LTL）和纤维肝附件（AFH）之间的解剖，以免在解剖LTL时切断AFH. MethodsTotal 43和27例尸体肝脏进行了大体和组织学检查，分别。这可能是为什么AFH经常与LTL一起解剖的原因。LTL与AFH的关系有两种类型，一种是LTL的起点在左肝，另一种是在AFH。27例AFH中25例有胆管残端，12例有较大的胆管，无一例伴有发达的胆管周围血管丛。AFH形态多样，包括矩形（6/43）、长三角形（4/43）、短三角形（7/43）、三角形加条索形（11/43）、条索形（12/43）和分叉型（3/43）。建议外科医生不仅通过电烙术而且通过牢固地结扎其残端来切断AFH。
BackgroundThe aim of the present study was to clarify the anatomy between the left triangular ligament (LTL) and the appendix fibrosa hepatis (AFH) in order not to sever the AFH when dissecting the LTL.MethodsTotals of 43 and 27 cadaveric livers were examined macroscopically and histologically, respectively.ResultsThe LTL attached itself to the diaphragmatic surface of the AFH through almost all lengths of the AFH. This might be the reason why AFH is so often dissected together with the LTL. There were two types of relation between the LTL and the AFH; in one type, the starting point of the LTL existed on the left liver and in the other type, it was on the AFH. Twenty-five of 27 AFH included remnants of the bile duct and 12 of 25 AFH had comparatively large bile ducts, which was unexceptionally accompanied by the well-developed peribiliary vascular plexus. AFH showed a variety of shapes, such as rectangular (6/43), long triangular (4/43), short triangular (7/43), triangular plus cordlike (11/43), cordlike (12/43) and bifurcated (3/43) types.ConclusionsAs AFH sometimes includes relatively large bile ducts, it is recommended for surgeons to sever the AFH not just simply by electrocautery but by ligating its stump securely.