天津医药

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活体右半肝供者肝脏血管和胆道解剖变异分析

王浩1,郭庆军2,潘澄2,邓永林3,沈中阳4,曾志贵5,朱志军6,蒋文涛6,郑虹6,魏林6   

  1. 1. 天津医科大学研究生院；天津市第一中心医院移植外科
    2. 天津市第一中心医院移植外科
    3. 第一中心医院移植外科
    4. 天津市第一中心医院器官移植中心
    5.
    6. 天津市第一中心医院
  • 收稿日期:2010-04-28 修回日期:2010-09-18 出版日期:2011-02-15 发布日期:2011-02-15
  • 通讯作者: 王浩

The anatomic variations of vessels and biliary tract in right liver living donor

  • Received:2010-04-28 Revised:2010-09-18 Published:2011-02-15 Online:2011-02-15

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摘要： 【摘要】 目的 分析我中心活体肝移植右半肝供者血管、胆道解剖学特点及其出现的概率。方法 回顾性调查我中心单一外科小组90例右半肝活体肝移植供者的肝静脉、门静脉、肝动脉及胆道的解剖学特点。结果 正常门静脉的比例为94.4%（85/90），三叉型门静脉的比例为5.6%（5/90）；肝动脉变异率很高；正常胆道的比例为66.7%（60/90），三叉型胆道占20%（18/90），右前支胆道或右后支胆道汇入左肝管比例为12.2%（11/90）；4型胆道占1.1%（1/90）；肝中静脉和肝左静脉共干的比例为70.0%（63/90），大于5毫米的肝右下静脉出现机率为26.6%（24/90），左内叶上段静脉汇入肝左静脉的比例为68.8%（62/90），共同汇入肝左静脉和肝中静脉的比例为21.1%（19/90），汇入肝中静脉的比例为10.0%（9/90）。结论 肝脏血管和胆道的解剖变异很常见，准确的术前评估对于活体肝移植至关重要。

关键词: 活体肝移植, 供者, 解剖变异

Abstract: [Abstract] Objective To describe the vessels and biliary anatomical vatiations of the right liver living donor. Methods Surgical anatomy of vessels and biliary tract structures in 90 right lobe grafts of a single surgical team were reevaluated by reviewing the results of preoperative assessment.The data were analyzed in relation to surgical management of anatomical variations. Results Portal vein (PV): 94.4% had classic anatomy, 5.6% had a trifurcated PV. Hepatic artery (HA):The hepatic artery anatomic variations were very common. Biliary tree: 66.7% had normal anatomy; 20% had a trifurcated biliary anatomy; in 12.2% the right anterior bile duct or the right posterior bile duct opened into the left bile duct; 1.1% was of type 4. Hepatic veins:In 70.0% of the donor,the middle hepatic vein and the left hepatic vein have common trunk;Most(68.8%) veins of S4 import into the left hepatic vein;The incidence of right inferior hepatic vein was 26.6%,which were larger than 5mm.Conclusion The anatomic variations of the liver are very common, detailed and precise assessment of vascular and biliary anatomy is vital for appropriate surgical management.

Key words: living donor liver transplantation, right liver living donor, anantomic variations