Kamiya J, Nagino M, Nimura Y
Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, 466-8550 Nagoya, Japan.
Surg Radiol Anat. 2004 Feb;26(1):24-7. doi: 10.1007/s00276-003-0181-3. Epub 2003 Nov 25.
Hepatobiliary resection with caudate lobectomy has been conducted in the surgical treatment of bile duct carcinoma of the hepatic hilus. However, insufficient attention has been paid to the anatomy of the right portion of the caudate lobe, and techniques to visualize the portal branches of the right caudate lobe (P1r) have not been reported. Contrast medium was injected into the dorso-caudal branches of the middle hepatic vein (MHV) and images were obtained by digital subtraction venography. Retrograde portography of the P1r was achieved in 64 (84%) out of 76 cases. The mean number of visualized branches was 2.1 (137 out of 64) and the P1r coursed beyond the trunk of the MHV in 36 (56%) out of the 64 cases. Contrast medium flowed into the right portal vein from 59 P1r branches in 32 cases and into the left portal vein in 20 cases. No complications were encountered. Retrograde portograms of the P1r may provide valuable information not previously available to surgeons operating on the caudate lobe.
在肝门部胆管癌的外科治疗中已开展了包括尾状叶切除的肝胆切除术。然而，对尾状叶右侧部分的解剖结构关注不足，且尚未见关于显示尾状叶右门静脉分支（P1r）的技术报道。将造影剂注入肝中静脉（MHV）的背尾侧分支，并通过数字减影静脉造影获得图像。76例患者中有64例（84%）实现了P1r的逆行门静脉造影。可视化分支的平均数量为2.1条（64例中共137条），64例中有36例（56%）的P1r走行于MHV主干之外。32例中59条P1r分支的造影剂流入右门静脉，20例流入左门静脉。未出现并发症。P1r的逆行门静脉造影可为进行尾状叶手术的外科医生提供以前无法获得的有价值信息。
