门静脉左支矢状部的肝表面定位及其临床意义  

LOCATION OF THE SAGITTAL PART OF THE LEFT BRANCH OF THE PORTAL VEIN ON THE SURFACE OF THE LIVER AND ITS CLINICAL SIGNIFICANCE

作　　者：王炳高[1] 王守彪[2] 夏玉军[2] 梅广东[2] 刘志才[2] 单涛[2] 

机构地区：[1]青岛大学医学院第二附属医院乳腺外科,山东青岛266042 [2]青岛大学医学院人体解剖学教研室

出　　处：《齐鲁医学杂志》2004年第2期130-131,共2页Medical Journal of Qilu

摘　　要：①目的　探讨门静脉左支矢状部的暴露途径 ,为右三肝叶和肝左外叶切除提供解剖学基础。②方法取 30例成人肝标本 ,以肝镰状韧带和左纵沟所在的平面为中心 ,向两侧行平行连续性切面以观测门静脉左支矢状部及其分支情况。③结果　矢状部、囊部的左右侧和角部的左右侧在肝膈面的对应点三维坐标 (单位均为cm)分别为 (0 .6 5、4 .6 4、4 .35 ) ,(- 0 .4 5、4 .72、4 .4 0 ) ,(0 .5 5、6 .6 5、3.76 ) ,(- 0 .4 5、6 .6 7、3.70 ) ;在肝脏面对应点三维坐标分别为 (0 .6 6、4 .5 0、2 .74 ) ,(- 0 .4 5、4 .5 4、2 .4 0 ) ,(0 .5 0、6 .5 1、2 .76 ) ,(- 0 .5 1、6 .5 4、2 .70 )。④结论　在肝脏面左纵沟右 0 .5cm处做切口较易暴露处理门静脉左支矢状部的右侧分支 ;在肝的膈面镰状韧带左 0 .7cm处做切口可以较为容易地结扎门静脉左支矢状部的左侧分支 。Objective To investigate the surgical approaches to the sagittal part of the left branches of portal vein and to provide anatomic basis for lobectomy of liver. Methods The sagittal part of portal vein and its branches were observed in the continuous section of 30 specimens of adult cadaveric liver, based on the section of hepatic falciform ligament and left sagittal groove. Results On the diaphragmatic surface of the liver, the projecting points of the left and right sides of the gall bladder and the sagittal angle were marked by three-dimensional coordinate of (0.65,4.64,4.35), (-0.45,4.72,4.40), (0.55,6.65,3.76), and (-0.45,6.67,3.70), respectively. On the visceral surface, these points were marked by three-dimensional coordinate of ( 0.66, 4.50,2.74 ), (-0.45,4.54,2.40 ), (0.50,6.51,2.76) and (-0.51,6.54,2.70). Conclusion The right branches of the sagittal part are easy to be exposed at the right 0.5 cm of the left sagittal groove on the diaphragmatic surface of the liver. The injury of the main stem of the sagittal part can be avoided by making an incision on the left 0.7 cm of the hepatic falciform ligament on diaphragmatic surface and legating left branches of the left portal vein.

关 键 词：门静脉 肝表面定位 肝切除术 肝镰状韧带 

分 类 号：R657.3[医药卫生—外科学]