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Kelly钳精细钳夹法切肝技术的临床应用
  • 期刊名称:中华肝脏外科手术学电子杂志2013
  • 时间:2013.8.8
  • 页码:43-46
  • 分类:R323.1[医药卫生—人体解剖和组织胚胎学;医药卫生—基础医学]
  • 作者机构:[1]昆明医科大学第四附属医院普通外科三区,650031
  • 相关基金:基金项目:受国家自然科学基金面上项目资助(81060041)
  • 相关项目:应力刺激对肝再生的影响及其Ras/MAPK信号途径调节机制的研究
中文摘要:

目的观察肝右后叶Glisson鞘的解剖结构及走行分布情况,为实施右后叶精准肝切除术提供解剖学基础。方法通过20例成人无病变尸体肝脏的剥离解剖,对肝右后叶Glisson鞘进行形态学观察,采集相关数据并进行统计学分析。结果右后支Glisson鞘存在共干和无共干的分别占95%和5%,G右后/G右前的夹角为(81.4±13.8)°;30%的右后支Glisson鞘呈Y型与V型,Y型中G6/G7的夹角为(71±3.92)°;70%右后支Glisson鞘主干呈C型,辐射状三级分支数目为3—8支不等。结论右后叶Glisson鞘走行分布情况并不完全符合Couinaud分段的描述,且存在明显的个体差异。在实施精准肝切除术之前了解右后叶Glisson鞘的解剖,有助于降低手术风险,减少术后并发症。

英文摘要:

Objective To study the anatomical structure and the distribution of the right posterior sectional Glissonean pedicle so as to provide the anatomical basis for liver resection of the right posterior section. Method By studying the morphological features of the right posterior sectional Glissonean pedicle through peeling and dissecting 20 adult corpses without liver pathological. Result In 95 % of the right posterior sectional Glissonean pedicles there were shared branches. The angle between the GRL/GRA was 81.4° ± 13.8°. In 30%, the right posterior sectional Glissonean pedicle presented as a Y or a V. In a Y shaped, the angle between G6/G7 was 71 ° ± 3.92°. The shapes of 70% of the right posterior sectional Glissonean pedicle presented as a C. The number of branches at the tertiary level was between 3-8. Conclusion The distribution of the right posterior sectional of the Glissonean pedicle did not entirely fit the description of Couinaud's segments. Obvious individual differences existed. Under this circumstance, understanding the anatomy of the right posterior sectional Glissonean pedicle before carrying out partial hepatectomy would be helpful in reducing surgical risks and postoperative complications.

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