Birincioglu Ismail, Topaloglu Serdar, Turan Nursen, Cekic Arif Burak, Ak Huseyin, Cinel Akif, Turkyilmaz Serdar, Piskin Burhan
Department of Forensic Medicine, Karadeniz Technical University, School of Medicine, Trabzon, Turkey.
Hepatogastroenterology. 2011 Mar-Apr;58(106):311-7.
BACKGROUND/AIMS: There are few anatomical studies on hepatic vein compared to hepatic artery and portal vein. The aim of this study is to clarify the branching patterns of hepatic veins, supra and infra-diaphragmatic course of suprarenal inferior vena cava and its relation with the liver.
Between March and May 2008, 103 consecutive autopsy examinations were included in the study. Hepatic vein anatomy was classified according to the Broelsch classification. The anatomic relations of supra-diaphragmatic and infra-diaphragmatic (suprarenal) inferior vena cava were revealed.
Majority of subjects have Type a (42.7%) variation. The inferior right hepatic vein was presented alone in 26 and together with middle right hepatic vein in 15 subjects. Most of the phrenic veins were drained to the right-anterior sidewall of inferior vena cava (n=21/25 above the diaphragm and, n=144/306 below the diaphragm). Drainage of the right adrenal vein directly into the right side of the inferior vena cava was found in 82 subjects (80%). Most of subjects had 2 lumbar branches in the posterior sidewall of infradiaphragmatic inferior vena cava (n=92/103).
The proposed classification of hepatic veins and obtained anatomical details from this study provides useful assistance for hepatic surgeons in phases of operative planning and vascular control maneuvers required in liver surgery.
背景/目的：与肝动脉和门静脉相比，关于肝静脉的解剖学研究较少。本研究的目的是阐明肝静脉的分支模式、肾上腺下腔静脉在膈上和膈下的走行及其与肝脏的关系。
2008年3月至5月期间，本研究纳入了103例连续的尸检。肝静脉解剖根据布罗尔施分类法进行分类。揭示了膈上和膈下（肾上腺）下腔静脉的解剖关系。
大多数受试者有a型（42.7%）变异。右下肝静脉单独出现的有26例，与右中肝静脉一起出现的有15例。大多数膈静脉汇入下腔静脉的右前侧壁（膈上n = 21/25，膈下n = 144/306）。82例受试者（80%）发现右肾上腺静脉直接汇入下腔静脉右侧。大多数受试者在膈下下腔静脉后壁有2支腰静脉分支（n = 92/103）。
本研究提出的肝静脉分类及获得的解剖学细节为肝脏外科医生在肝脏手术的手术规划和血管控制操作阶段提供了有用的帮助。
