Cho Akihiro, Okazumi Shinichi, Makino Harufumi, Miura Fumihiko, Ohira Gaku, Yoshinaga Yushin, Toma Takayuki, Kudo Hidehiro, Matsubara Katsuhiko, Ryu Munemasa, Ochiai Takenori
Department of Academic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, 260-0856 Chuou-ku, Chiba, Japan.
World J Surg. 2004 Jan;28(1):8-12. doi: 10.1007/s00268-003-7038-0. Epub 2003 Dec 4.
Although a right liver graft without a middle hepatic vein resulted in potential venous congestion in the right paramedian sector, the details of the hepatic venous distribution in the right paramedian sector have not been established. In this study, the ramification patterns of the hepatic veins draining the right anterosuperior segment (S8) and the relation between the hepatic and portal veins were assessed using multislice computed tomography in 44 patients without lesions in the liver. All 52 drainage veins of the ventral area of S8 joined the middle hepatic vein, and all 48 drainage veins of the dorsal area joined the right hepatic vein. The hepatic vein crossing between the ventral and dorsal areas was observed in each patient examined. Therefore, we propose a reclassification wherein the right paramedian sector is divided into ventral and dorsal segments. This new classification may contribute to the development of new and safer surgical procedures, including more limited resection and right lobe adult living donor liver transplantation to avoid graft congestion.
尽管没有肝中静脉的右肝移植会导致右旁正中区域出现潜在的静脉淤血，但右旁正中区域肝静脉分布的细节尚未明确。在本研究中，我们使用多层计算机断层扫描对44例无肝脏病变的患者评估了引流右前上段（S8）的肝静脉分支模式以及肝静脉与门静脉之间的关系。S8腹侧区域的所有52条引流静脉均汇入肝中静脉，背侧区域的所有48条引流静脉均汇入右肝静脉。在每例接受检查的患者中均观察到肝静脉在腹侧和背侧区域之间交叉。因此，我们提出一种重新分类方法，即将右旁正中区域分为腹侧段和背侧段。这种新的分类可能有助于开发新的、更安全的手术方法，包括更有限的切除术和右叶成人活体肝移植，以避免移植肝淤血。
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