Department of Surgery and Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea.
Surgery. 2011 Feb;149(2):291-6. doi: 10.1016/j.surg.2009.11.008. Epub 2010 Jan 15.
At the hilum of the liver, there is a structure called the hilar plate, which is of great surgical importance because all variations in the bile ducts and blood vessels occur within this region. The Rex-Cantlie line does not always pass the point of portal bifurcation. Classifying portal vein (PV) variations based on the shape and origin of anterior sectoral trunk (AST) within the hepatic plate system will be of higher anatomical and surgical value than the conventional method based on PV ramification.
We investigated PV variations in the hilar plate in terms of combinations of 4 hepatic sectoral trunks rather than successive ramification of the PV. The combination patterns of each sectoral trunk were analyzed using data from adult cadaver liver dissection (n = 64) and multi-detector computed tomography (n = 216) of human livers.
The AST root position on the hilar plate varies, in contrast to the other sectoral trunks, which are relatively consistent in their root position. Three types of PV variations were identified based on the AST root position. In addition, 4 similar but different shapes (I, Y, V, and U) of AST were identified.
Not only the root position in the hepatic hilar plate but also the shape of AST can be considered as the major determinants of PV variations.
在肝脏门脉处，有一个称为门脉隆突的结构，由于所有胆管和血管的变异都发生在这个区域，因此具有重要的手术意义。Rex-Cantlie 线并不总是通过门静脉分叉点。基于肝板系统内前节段干（AST）的形状和起源对门静脉（PV）变异进行分类，将比基于 PV 分支的传统方法具有更高的解剖学和手术价值。
我们研究了门脉隆突处的 PV 变异，根据 4 个肝段支干的组合，而不是 PV 的连续分支。使用成人尸体肝解剖（n=64）和人体肝脏多探测器 CT（n=216）的数据，分析了每个节段支干的组合模式。
AST 根部在门脉隆突上的位置不同，而其他节段支干的根部位置相对一致。根据 AST 根部位置确定了 3 种类型的 PV 变异。此外，还确定了 4 种相似但不同形状（I、Y、V 和 U）的 AST。
不仅门脉隆突中的根部位置，AST 的形状也可以作为 PV 变异的主要决定因素。
