Rat P, Favre J P, Paris P, Sakka M
Université de Bourgogne, Service de Chirurgie viscérale, CHU Dijon.
Chirurgie. 1991;117(5-6):364-70; discussion 370-1.
It is possible to obtain two hepatic transplants from a single cadaveric liver by separation or right and left livers or by separation of the right lobe from the left lobe medial to the umbilical cleft. We attempt to define the ideal basis of separation of the structures of the portal pedicle, based on anatomical study of 25 livers. One should ideally section the left portal vein, the right branch of the hepatic artery, the left hepatic duct. The segment I must be systematically resected, the segment IV must be resected after a separation of the right lobe from the left lobe. A cholangiogram and an arteriogram are indispensable prior to hepatic division.
通过分离左右肝叶或从脐裂内侧将右叶与左叶分离,从单个尸体肝脏获取两个肝移植供肝是可行的。基于对25个肝脏的解剖学研究,我们试图确定门静脉蒂结构分离的理想基础。理想情况下,应切断左门静脉、肝动脉右支、左肝管。必须系统性地切除I段,在右叶与左叶分离后切除IV段。在肝脏分割之前,胆管造影和动脉造影是必不可少的。