Third Department of General Surgery, University of Milan, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, 20089 Rozzano, Milan, Italy.
Br J Surg. 2010 Dec;97(12):1867-73. doi: 10.1002/bjs.7230. Epub 2010 Aug 26.
The presence of communicating veins between adjacent hepatic veins may allow parenchyma-sparing hepatectomy. Taking advantage of improvements in ultrasound technology, such as e-flow modality, a study of the presence of communicating veins was conducted in patients with hepatic tumours at the caval confluence.
Consecutive patients undergoing surgery between October 2007 and December 2009 for hepatic tumours in contact with or invading a hepatic vein at its caval confluence were included. Communicating vein mapping by means of e-flow intraoperative ultrasonography (EF-IOUS) was carried out.
A total of 20 patients were enrolled. Communicating veins between adjacent hepatic veins or with the inferior vena cava were detected in 16 patients. The median number of communicating veins was 1 (range 0-5). The total number of lesions removed was 126 (range 1-46). In 11 of 12 patients requiring resection of a hepatic vein, communicating veins enabled a parenchyma-sparing procedure to be performed. No patient had a formal major hepatectomy. There was no postoperative mortality or major morbidity.
EF-IOUS estimation of the frequency of communicating veins between adjacent hepatic veins suggests that such veins are common. This may facilitate parenchyma-sparing procedures in patients with hepatic tumours encroaching on major hepatic veins.
相邻肝静脉之间存在交通静脉可能允许进行保留肝实质的肝切除术。利用超声技术的改进，如 e-flow 模式，对腔静脉汇合处肝肿瘤患者交通静脉的存在进行了研究。
连续纳入 2007 年 10 月至 2009 年 12 月期间因肝静脉汇合处接触或侵犯肝肿瘤而行手术的患者。通过术中超声的 e-flow 进行交通静脉成像。
共纳入 20 例患者。在 16 例患者中检测到相邻肝静脉或下腔静脉之间的交通静脉。交通静脉的中位数为 1 条（范围 0-5 条）。总共切除的病灶数为 126 个（范围 1-46 个）。在 12 例需要切除肝静脉的患者中有 11 例，交通静脉使得能够进行保留肝实质的手术。没有患者行正式的大范围肝切除术。没有术后死亡或重大并发症。
e-flow 对相邻肝静脉之间交通静脉频率的估计表明，这种静脉很常见。这可能有助于侵犯主要肝静脉的肝肿瘤患者进行保留肝实质的手术。
