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肝表面小沟在肝切除术中的实际应用价值

Practical usefulness of minor grooves of the hepatic surface for liver resection.

作者信息

Lee Jae Hoon, Lee Sang Yeup, Hwang Dae Wook, Park Kwang-Min, Lee Young-Joo

机构信息

Department of Surgery, Asan Medical Center, Seoul, Korea.

出版信息

Hepatogastroenterology. 2012 Mar-Apr;59(114):458-60. doi: 10.5754/hge11415.

Abstract

BACKGROUND/AIMS: The clinical relevance of grooves of the hepatic surface has not been clearly identified. The aim of the present study was to examine the association of minor grooves and liver segmentations, and to evaluate the usefulness of grooves for liver resection.

METHODOLOGY

Between January 2005 and December 2010, 482 patients with hepatic resection for liver disease were included in this study. We performed glissonean pedicle transection methods for hepatic resection to identify sectors or segments of the liver and examined location, size, depth and relationship with intersegmental line of the hepatic grooves.

RESULTS

Diaphragmatic grooves were located on anatomical border between right lobe and left lobe and within right anterior sector. The minor grooves were more commonly observed in the right lobe than in the left lobe. The minor grooves between segment V and VI, and segment V and VI were easy to perform monosegmentectomy and right anterior sectionectomy on, respectively. These minor grooves were also helpful to determine the resection margin for non-anatomical resection.

CONCLUSIONS

Minor grooves were often observed in line with sector or segment, or near to inter-segmental or sectorial border. The anatomical knowledge of hepatic grooves including minor type may be of help for hepatobiliary surgeons and radiologists to understand liver segmentation.

摘要

背景/目的:肝表面沟的临床相关性尚未明确。本研究旨在探讨肝小沟与肝段划分的关系,并评估肝沟在肝切除术中的应用价值。

方法

2005年1月至2010年12月,本研究纳入482例行肝切除术治疗肝脏疾病的患者。我们采用肝门蒂横断法进行肝切除术,以确定肝脏的肝段或肝叶,并检查肝沟的位置、大小、深度以及与肝段间线的关系。

结果

膈面沟位于右叶与左叶的解剖边界以及右前叶内。肝小沟在右叶比在左叶更常见。V段与VI段之间以及V段与VI段之间的肝小沟分别便于进行单段切除术和右前叶切除术。这些肝小沟也有助于确定非解剖性切除的切缘。

结论

肝小沟常与肝叶或肝段一致,或靠近肝段间或肝叶间边界。包括小沟型在内的肝沟解剖知识可能有助于肝胆外科医生和放射科医生理解肝段划分。

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