显露和切开肝内各叶段胆管手术进路选择的解剖基础与临床体会  

CLINICAL REALIZATION AND ANATOMIC BASIS FOR SELECTING APPROACHES TO EXPOSE AND INCISE EACH SEGMENTAL INTRAHEPATIC DUCT

作　　者：王炳煌[1] 张小文[1] 张天玉[1] 李立春[1] 李晓[1] 王华[1] 

机构地区：[1]昆明医学院第二附属医院肝胆胰外科,昆明650101

出　　处：《现代手术学杂志》1997年第2期86-89,共4页

摘　　要：为适应现代肝胆外科肝内胆道手术技术的需要,选择可行的手术进路,研究新的手术方法。作者观察了30个人肝标本的肝内各叶、段胆管与相应门静脉、肝动脉分支走行、位置的解剖关系。结果表明:肝门胆管、左右肝管及左内叶胆管的显露和切开应从脏面进路。右肝内各叶、段胆管的显露和切开则膈面进路优于脏面进路。上述进路用于临床手术治疗复杂肝内胆管多发结石并多处胆管狭窄35例取得成功。The authors studied 30 human liver specimens of adults, and observed the position and anatomic relation of each lobal and segental bile duct as well as the portal branches and the hepatic arterial branches. Results showed that the bile duct of the liver hilus, left or right hepatic ducts should be approached via the visceral face of the liver, the right hepatic lobal and segmental ducts were better approached via the diaphragmatic surface of the liver. Above approaches were taken in 35 case for complex intrahepatic multiple stones with multiple lobal and segmental bile duct strictures with success.

关 键 词：肝叶 胆管手术 进路选择 解剖基础 肝切除术 手术径路 

分 类 号：R657.4[医药卫生—外科学]