The role of hepatic veins in liver operations.
The role of hepatic veins in liver operations.
复制标题
肝静脉在肝脏手术中的作用。
作者：
Q. Ou;R. Hermann
在本报告中，我们回顾了肝静脉在肝脏切除手术中的作用。重点是肝静脉的分布、它们与肝动脉和门静脉流入道的关系以及肝小叶的引流模式。对较早文献的广泛回顾强调有必要保留各个肝段的肝静脉引流，以防止术后肝脏充血和损伤。最近的实验和临床报告已经确定了可以很好地耐受肝静脉阻塞的机制。这些机制包括叶间和小叶间侧枝发育、门静脉血流逆转、门静脉转变为流出道、肝外侧枝发育、通过尾状叶引流以及增加淋巴引流以缓解肝充血。
In this report we review the role of the hepatic veins in resective operations of the liver. Emphasis is placed on the distribution of the hepatic veins, their relationship to hepatic arterial and portal venous inflow tracts, and the drainage patterns of hepatic lobules. An extensive review of the older literature has emphasized the necessity to preserve hepatic venous drainage for the various hepatic segments to prevent postoperative liver congestion and injury. Recent experimental and clinical reports have identified the mechanisms through which hepatic vein obstruction can be well tolerated. These mechanisms include interlobar and interlobular collateral development, reversal of blood flow in the portal vein with conversion of the portal vein to an outflow tract, development of extrahepatic collaterals, drainage through the caudate lobe, and increased lymphatic draining to relieve hepatic congestion.