Jones R M, Hardy K J
Victorian Liver Transplant Unit, University of Melbourne, Department of Surgery, Austin Campus, Melbourne 3084, Australia.
J R Coll Surg Edinb. 2001 Jun;46(3):168-70.
This study was carried out to document the anatomy of the hepatic artery with the purpose of reminding surgeons of the need for this essential knowledge in order to practice safe hepatobiliary surgery. Repeated surgical mistakes on patients referred to our unit prompted the study. One hundred and eighty consecutive livers procured for transplantation was studied, and the anatomy drawn immediately after dissection. The left hepatic artery arose from the left gastric artery in 15%, and either the splenic, gastroduodenal artery or the aorta in 4% of cases. The right hepatic artery arose from the superior mesenteric artery in 15%, the gastroduodenal, right gastric artery or aorta in 10% of cases. There was a major variation of the coeliac axis in 9% of cases studied. Overall, there was an abnormality in 43% of dissections: 48% were multiple and 27% had more than two vascular variations. A constant pattern of abnormalities occurred in the anatomy of the hepatic artery. Realisation of this vascular pattern should make identification of the anatomy easier. When there is one vascular variation, there is a high chance of there being multiple variations.
本研究旨在记录肝动脉的解剖结构，目的是提醒外科医生掌握这一基本知识对于安全开展肝胆手术的必要性。转诊至我院的患者反复出现手术失误促使了本研究的开展。对连续获取的180例用于移植的肝脏进行研究，并在解剖后立即绘制其解剖结构。左肝动脉在15%的病例中起源于胃左动脉，在4%的病例中起源于脾动脉、胃十二指肠动脉或主动脉。右肝动脉在15%的病例中起源于肠系膜上动脉，在10%的病例中起源于胃十二指肠动脉、胃右动脉或主动脉。在所研究的病例中，9%存在腹腔干的主要变异。总体而言，43%的解剖存在异常：48%为多处异常，27%有两种以上血管变异。肝动脉解剖结构中出现了一种恒定的异常模式。认识到这种血管模式应会使解剖结构的识别更加容易。当存在一种血管变异时，很有可能存在多种变异。
