Shilal Poonam, Tuli Anita
Assistant Professor, Department of Anatomy, Sikkim Manipal Institute of Medical Sciences , Shilal Building, Forest Colony Road, Gangtok, Sikkim, India .
Professor and Head, Department of Anatomy, Lady Hardinge Medical College , Connaught Place, Delhi, India .
J Clin Diagn Res. 2015 Mar;9(3):AC08-12. doi: 10.7860/JCDR/2015/8736.5671. Epub 2015 Mar 1.
The pattern of drainage in the right posterior lobe of liver varies considerably. The knowledge of this variation is very important while performing various surgeries on the right posterior lobe.
A study was conducted to see the variations in the pattern of drainage of posterior segment of the right lobe of liver. The aim was to see the variations of right hepatic vein and small accessory hepatic veins draining the posterior segment, the presence of which led to modifications in drainage of posterior segment.
Sixty formalin fixed adult human liver specimens were dissected manually.
According to the pattern of drainage of tributaries of right hepatic vein, the right hepatic vein was classified into type I, type II, type III and type IV. According to presence of inferior right hepatic vein, three types of drainage of posterior lobe were seen: Type I, (76.36%) right hepatic vein was large, draining wide area of posterior segment. A small inferior right hepatic vein drained the small area of posterior segment. In Type II, (19.92%) both right hepatic and inferior right hepatic veins were medium sized draining the posteroinferior segment of the right lobe concomitantly. In Type III, (32%) accessory veins, the middle right hepatic vein drained the posterosuperior (VII) as well as the posteroinferior (VI) segment. In one specimen, there were numerous middle right hepatic veins draining the right posterior segment. The knowledge of anatomic relationship of veins draining right lobe, is important in performing right posterior segmentectomy.
For safe resection of the liver, the complex anatomy of the distribution of the tributaries of the right hepatic vein and the accessory veins have to be studied prior to any surgery done on liver.
肝右后叶的引流模式差异很大。在对右后叶进行各种手术时,了解这种变异非常重要。
进行一项研究以观察肝右叶后段引流模式的变异。目的是观察引流后段的右肝静脉和小副肝静脉的变异,其存在导致后段引流的改变。
手动解剖60例福尔马林固定的成人肝脏标本。
根据右肝静脉属支的引流模式,右肝静脉分为I型、II型、III型和IV型。根据右下肝静脉的存在情况,观察到后叶的三种引流类型:I型,(76.36%)右肝静脉粗大,引流后段的大片区域。一条小的右下肝静脉引流后段的小区域。II型,(19.92%)右肝静脉和右下肝静脉均中等大小,同时引流右叶的后下段。III型,(3.2%)有副静脉,右肝中静脉引流后上段(VII段)以及后下段(VI段)。在一个标本中,有许多右肝中静脉引流右后段。了解引流右叶的静脉的解剖关系,对进行右后段切除术很重要。
为了安全地进行肝脏切除,在对肝脏进行任何手术之前,必须研究右肝静脉属支和副静脉分布的复杂解剖结构。