活体肝移植肝左静脉的应用解剖  

Anatomy of the left hepatic vein and the application in liver transplantation

作　　者：李彦彦[1] 钱学华[1] 周庭永[1] 张琳[1] 王剑华[1] 刘本菊[1] 吕发金[2] 

机构地区：[1]重庆医科大学解剖学教研室,重庆400016 [2]重庆医科大学第一附属医院放射科,重庆400016

出　　处：《中国临床解剖学杂志》2009年第2期147-150,155,共5页Chinese Journal of Clinical Anatomy

摘　　要：目的:观测肝左静脉的解剖结构,为活体肝移植供肝切取和供肝肝左静脉与受体静脉吻合提供解剖学基础。方法:通过50例成人无病变肝脏剥离解剖,对肝左静脉进行形态学观测,采集相关数据并进行统计分析。结果:肝左静脉(LHV)与肝中静脉(MHV)共干和非共干者分别为80.00%(40/50)和20.00%(10/50);共干血管长度及其近端直径是(5.09±2.78)mm和(12.02±1.91)mm,非共干LHV与MHV开口间距离为(2.00±1.15)mm;LHV肝外段长度为(9.89±4.86)mm;LHV主干(96.00%,48/50)居镰状韧带左侧,成(35.31±16.79)°角;LHV主干长度及其近端直径为(39.1±15.16)mm、(8.44±1.28)mm;LHV的引流段变化较大,依据属支的多少可分5型。结论:LHV多与MHV共干注入IVC,LHV肝外段和外科干长度以及LHV的投影个体差异甚大,活体肝移植前掌握供肝LHV主干及其属支的解剖,有助于设计合理的手术方案。Objective： To survey anatomic features of the left hepatic vein（LHV）, and provide anatomical basis for liver transplantation. Methods： 50 healthy adult cadaveric livers were dissected. The morpbologic data of LHV were measured and analyzed statistically. Results： The occurrence of common trunk of LHV and middle hepatic vein（MHV） were 80.00 % （40/50）, and of LHV opening to IVC alone 20.00 % （8/40）. The length and proximal diameter of common trunk vein were （5.09±2.78）mm and （12.02±1.91）mm respectively. The distance between the site of MHV opening to IVC and the site of LHV opening to IVC was （2.00± 1.15）mm. The extrahepatic length of LHV was （9.89±4.86）mm. For 48 of 50 cases, the main trunk of LHV were at the left of falciform ligament of liver, with the average angle between them of （35.31± 16.79）°. The length of the main trunk of LHV and the distal diameter of LHV were （39.1 ±15.16）mm and （8.44±1.28）mm respectively. Obvious variation can be found at the LHV draining hepatic segment, which were divided into 5 types according to the number of its principle tributaries. Conclusions： The majority of LHV and MHV formed a common trunk before the abouchcment to IVC. Individual variations existed at the extrahepatic segment of LHV, surgical trunk and principle tributary of LHV. The anatomy of the main trunk and principle tributary of LHV is helpful for selecting rational operation plan during liver transplantation.

关 键 词：肝左静脉 应用解剖 活体肝移植 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学]