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Hepatic Segmentation and Intrahepatic Venous Drainage System in the Right Surgical Lobe of the Human Liver, Especially in the Posterior Sector.

人类肝脏右叶手术肝分割和肝内静脉引流系统，特别是后段。

基本信息

批准号：
10671203
负责人：
HATA Fumitake
金额：
$ 0.9万
依托单位：
Sapporo Medical University School of Medicine
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1998
资助国家：
日本
起止时间：
1998 至 1999
项目状态：
已结题

项目摘要

We describe the pattern of intrahepatic vessels ramification in the right surgical lobes of 197 livers by the method of dissection. Firstly, the right posterior segments could be identified based on the ramification patterns of the intrahepatic portal veins in 51.7% of the cases as follows.1)The posterior sectorial trunk was simply divided into segmental portal branches VIRUS (P6) and segmental portal branches VII (P7) trunks, S6 and S7 were readily identified based on the territories of P6 and P7, respectively.2) Although the posterior sectorial trunk was absent, both S6 and S7 were identifiable from the portal ramification pattern since either P6 and P7 formed a single trunk. The three hepatic veins (RHV, SHV, MHV) often did not aid the identification of the liver segments in the region. Consequently, the less than ideal combinations of irregular configurations of the portal and hepatic venous systems suggested that the right posterior segments cannot be conclusively identified anatomically in 30-40% of cases. Secondly, on the lower region of the right love, the RHV, SHV and MHV showed complementary venous drainage relationships. In the upper region of the right lobe various names have been given to the thick venous tributaries, we systematically classified these tributaries into 5 types of "right superior radicles" (RSR), according to their topographical relationships with the right superior portal branches (P7 and P8), RHV, MHV, SHVs and their tributaries. Our morphometric examination of the upper region revealed that the sizes of P7 and P8 increased or decreased simultaneously, and suggested that the RSRs played limited roles in venous return. Overall, the venous return did not seem to converge into a single particular vein, but was carried away by multiple superior veins: the RHV, MHV, SHVs and 5 RSRs.

本文用解剖方法描述了197例肝右叶内肝血管分支的形态。根据肝内门静脉的分支类型，右后段的识别率为51.7%：（1）后段干可简单分为段性门静脉支VIRUS（P6）和段性门静脉支VII（P7）干，S6和S7可根据P6和P7的分布区容易识别; 2）虽然后扇形干缺失，但由于P6和P7形成单一干，因此S6和S7均可从门静脉分支模式中识别。三条肝静脉（RHV、SHV、MHV）往往不能帮助识别该区域的肝段。因此，门静脉系统和肝静脉系统的不规则构型的不太理想的组合表明，在30-40%的病例中，右后段不能在解剖学上最终识别。在右下肢，右肝静脉、右肝静脉和中肝静脉呈互补性静脉回流关系。在右叶上部，静脉粗支有不同的名称，根据其与门静脉右上级支（P7和P8）、RHV、MHV、SHV及其分支的位置关系，将其分为5种类型：右上级根（RSR）。我们对上区的形态测量显示，P7和P8的大小同时增加或减少，这表明RSRs在静脉回流中的作用有限。总体而言，静脉回流似乎并未汇聚到单一特定静脉中，而是被多条上级静脉带走：RHV、MHV、SHV和5条RSRs。