Honma Satoru, Matsuda Wakoto, Kudo Motoi
Division of Morphological Neuroscience, Department of Anatomy, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, Japan.
Anat Sci Int. 2013 Mar;88(2):93-6. doi: 10.1007/s12565-012-0134-1. Epub 2012 Apr 11.
The topographic relationship between arteries and hepatobiliary ducts can be crucial during cholecystectomy. We observed the right hepatic artery traveling a rare route in a 91-year-old male. The common hepatic artery gave off the left hepatic, the right gastric, the gastroduodenal, and the right hepatic arteries consecutively without forming the proper hepatic artery. The right hepatic artery crossed the common bile duct anteriorly, ascended on the right side of the duct, passed the cystic duct posteriorly, and entered the right lobe of the liver. The so-called 9 o'clock artery running on the right side of the common hepatic and common biliary is reasonably speculated to be the aberrant right hepatic artery as presently shown. Developmental and clinical issues are discussed.
在胆囊切除术中,动脉与肝胆管的局部解剖关系可能至关重要。我们观察到一名91岁男性的右肝动脉走行罕见。肝总动脉依次发出左肝动脉、胃右动脉、胃十二指肠动脉和右肝动脉,未形成肝固有动脉。右肝动脉在胆总管前方交叉,在胆管右侧上升,在胆囊管后方通过,然后进入肝右叶。目前显示,在肝总动脉和胆总管右侧走行的所谓“9点钟动脉”合理推测为异常右肝动脉。文中讨论了发育和临床问题。