Hall Jon L, Mannion Paddy, Ladlow Jane F
Queen's Veterinary School Hospital, The University of Cambridge Veterinary School, University of Cambridge, Cambridge, United Kingdom.
Vet Surg. 2015 Jan;44(1):27-34. doi: 10.1111/j.1532-950X.2014.12209.x. Epub 2014 Jun 5.
To clarify canine intrahepatic portal and hepatic venous system anatomy using corrosion casting and advanced imaging and to devise a novel functional anatomic model of the canine liver to investigate whether this could help guide the planning and surgical procedure of partial hepatic lobectomy and interventional radiological procedures.
Prospective experimental study.
Adult Greyhound cadavers (n = 8).
Portal and hepatic vein corrosion casts of healthy livers were assessed using computed tomography (CT).
The hepatic lobes have a consistent hilar hepatic and portal vein supply with some variation in the number of intrahepatic branches. For all specimens, 3 surgically resectable areas were identified in the left lateral lobe and 2 surgically resectable areas were identified in the right medial lobe as defined by a functional anatomic model.
CT of detailed acrylic casts allowed complex intrahepatic vascular relationships to be investigated and compared with previous studies. Improving understanding of the intrahepatic vascular supply facilitates interpretation of advanced images in clinical patients, the planning and performance of surgical procedures, and may facilitate interventional vascular procedures, such as intravenous embolization of portosystemic shunts. Functional division of the canine liver similar to human models is possible. The left lateral and right medial lobes can be consistently divided into surgically resectable functional areas and partial lobectomies can be performed following a functional model; further study in clinically affected animals would be required to investigate the relevance of this functional model in the dog.
利用腐蚀铸型和先进成像技术阐明犬肝内门静脉和肝静脉系统的解剖结构,并设计一种新型犬肝功能性解剖模型,以研究其是否有助于指导部分肝叶切除术和介入放射学手术的规划及手术操作。
前瞻性实验研究。
成年灵缇犬尸体(n = 8)。
使用计算机断层扫描(CT)评估健康肝脏的门静脉和肝静脉腐蚀铸型。
肝叶具有一致的肝门部肝动脉和门静脉供血,肝内分支数量存在一定变异。根据功能性解剖模型,在所有标本中,左外侧叶确定了3个可手术切除区域,右内侧叶确定了2个可手术切除区域。
详细的丙烯酸铸型CT能够研究复杂的肝内血管关系,并与先前的研究进行比较。增强对肝内血管供应的理解有助于解读临床患者的先进影像、手术规划和操作,还可能有助于介入性血管手术,如门静脉体循环分流的静脉栓塞。犬肝的功能分区与人类模型相似是可行的。左外侧叶和右内侧叶可始终如一地划分为可手术切除的功能区域,部分肝叶切除术可按照功能模型进行;需要在临床患病动物中进一步研究,以探讨这种功能模型在犬类中的相关性。