Barbaro Brunella, Soglia Giovanna, Alvaro Giuseppe, Vellone Maria, Giuliante Felice, Nuzzo Gennaro, Bonomo Lorenzo
Department of Bioimaging and Radiological Sciences, School of Medicine, Catholic University, Largo A. Gemelli 1, Rome, Italy.
Abdom Imaging. 2013 Jun;38(3):442-60. doi: 10.1007/s00261-012-9900-8.
Hepatic resection is considered to be feasible when all malignant nodules can be technically excised. The goal of the surgical approach is to optimize the oncologic resection (negative margins), sparing the non-cancerous hepatic parenchyma. The outflowing hepatic vein (HV) of that particular liver remnant must be intact in order to preserve its function. The purpose of this article is to familiarize radiologists with anatomy and anatomical variants of HVs, with special emphasis on segmental venous drainage for presurgical planning of hepatic resections. We focus on information which radiologist should give to hepatic surgeon to choose proper surgical approach. Radiologist's familiarity with the anatomy and anatomical variants of HVs is essential for accurate surgical planning to avoid venous congestion as postoperative complication. Any clinically important hepatic vein variation detected on presurgical imaging should be carefully recorded in the radiology report.
当所有恶性结节在技术上都能被切除时,肝切除术被认为是可行的。手术方法的目标是优化肿瘤切除(切缘阴性),保留无癌的肝实质。为了保留其功能,该特定肝余叶的流出肝静脉(HV)必须完整。本文的目的是使放射科医生熟悉肝静脉的解剖结构和解剖变异,特别强调肝切除术前规划中的节段性静脉引流。我们关注放射科医生应向肝脏外科医生提供哪些信息,以便选择合适的手术方法。放射科医生熟悉肝静脉的解剖结构和解剖变异对于准确的手术规划至关重要,以避免静脉充血作为术后并发症。术前影像学检查中发现的任何具有临床重要性的肝静脉变异都应仔细记录在放射学报告中。