Furusawa Norihiko, Kobayashi Akira, Yokoyama Takahide, Shimizu Akira, Motoyama Hiroaki, Kanai Keita, Arakura Norikazu, Yamada Akira, Kitou Yoshihiro, Miyagawa Shin-Ichi
Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
Am J Surg. 2015 Aug;210(2):351-6. doi: 10.1016/j.amjsurg.2014.09.032. Epub 2015 Jan 29.
Among the intrahepatic bile ducts, the biliary system of the left medial sectional bile duct (B4) is known to have relatively complex patterns.
The records of 500 patients who had been diagnosed as having hepato-pancreatico-biliary disease were retrospectively studied for anatomical biliary variations of the left liver with special reference to the drainage system of B4 using magnetic resonance images.
The left hepatic duct was present in 494 patients (98.8%), whereas it was lacking in 6 patients (1.2%), and these patients exhibited the following B4 confluence patterns: B4 drained into the common hepatic duct in 2 patients (.4%), the right anterior sectional bile duct in 3 patients (.6%), and the right posterior sectional bile duct in 1 patient (.2%). The left hepatic duct was absent more frequently in patients with portal venous variations than in patients with a common branching pattern (8.2% vs .4%, P = .0011).
The presently reported data are useful for obtaining a better understanding of the surgical anatomy of the biliary system of the left liver.
在肝内胆管中，左内侧段胆管（B4）的胆道系统已知具有相对复杂的模式。
回顾性研究500例被诊断为肝胰胆疾病患者的记录，利用磁共振成像特别参照B4的引流系统研究左肝的解剖学胆道变异。
494例患者（98.8%）存在左肝管，而6例患者（1.2%）缺乏左肝管，这些患者表现出以下B4汇合模式：2例患者（0.4%）中B4汇入肝总管，3例患者（0.6%）中汇入右前叶胆管，1例患者（0.2%）中汇入右后叶胆管。门静脉变异患者中左肝管缺如的情况比具有共同分支模式的患者更常见（8.2%对0.4%，P = 0.0011）。
目前报告的数据有助于更好地理解左肝胆道系统的手术解剖结构。
