第一肝门的腹腔镜肝脏手术入路解剖学研究  

Study of the operation pathway of the porta hepatis on laparoscopic surgery

作　　者：李晓平[1] 周杰[1] 徐达传[2] 李朝龙[1] 

机构地区：[1]第一军医大学南方医院肝胆血管外科,广州510515 [2]第一军医大学解剖学教研室,广州510515

出　　处：《中国临床解剖学杂志》2004年第3期230-233,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的:为腹腔镜肝脏外科提供第一肝门的应用解剖及手术入路设计。方法:成人尸体肝脏标本30例结合临床手术入路设计,研究肝门静脉主干及其属支的管径、汇合形式及分支直径、长度(从分叉至进入肝实质),横沟的长度、门静脉分叉点与肝方叶尖、尾状叶尖的距离。观察肝门静脉左、右支在横沟内与左、右肝动脉及肝左、右管的伴行关系。结果:①肝门静脉在胰颈或胰体之后由肠系膜上静脉、脾静脉[直径分别为(11.42±2.85)mm、(7.91±3.06)mm]汇合而成。其汇合类型分为3型;②横沟呈槽状,长度为(4.19±0.36)cm;③肝门静脉左支长为(1.45±0.17)cm,直径为(11.97±1.65)mm;④门静脉右支长为(1.57±0.05)cm,直径为(11.75±0.98)mm。结论:腹腔镜下解剖分离第一肝门是可行的;肝门阻断入路操作简单,效果切实;还可以进行手术区域的肝门管道预处理及肝门静脉保护。Objective: To provide applied anatomy of the porta hepatis for operations of laparoscopic liver surgery and to design secure and convenient op eration pathways. Methods: Thirty antisepsis adult liver specimens were studied for the laparoscopic applied anatomy of the portal vein and transverse furrows. Results: ① There were 3 confluence forms in portal vein. ② The transverse furr ow appeared 'slot' shape and it's length was 4.19±0.36 cm. ③The length and dia meter of the left branch of the portal vein was 1.45±0.17 cm and 11.97±1.65 mm respectively. ④ The length and diameter of the right branch of the portal vein was1.57±0.05 cm and 11.75±0.98 mm. Conclusion: Laparoscopic dissection on por ta hepatis is feasible. Interruption of porta hepatis is simple and useful. We a lso can treat the porta hepatis tubing of the operation area and protect the por tal vein before resection.

关 键 词：腹腔镜 第一肝门 肝门静脉 手术入路 应用解剖 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学] R657.3[医药卫生—基础医学]