Anatomical Institute of Minimally Invasive Surgery, Southern Medical University, Guangzhou, China.
Department of Genaral Surgery of Guangzhou Integrated Traditional Chinese and Western Medicine Hospital, Guangzhou, China.
Sci Rep. 2017 Mar 21;7:44977. doi: 10.1038/srep44977.
Liver hanging maneuver (LHM) is an important technique in liver surgery. However, applied anatomy of the retrohepatic tunnel for the surgical approach in Chinese population needs further study. In this study, to explore the basic anatomy of retrohepatic tunnel and its clinical application in a Chinese population, a total of 32 formalin-fixed cadavers were dissected, related parameters were measured, and their clinical applications were discussed. The length of the retrohepatic tunnel was (60.6 ± 9.9) mm. The width of the retrohepatic tunnel superior opening was (13.8 ± 3.9) mm. The width of the retrohepatic tunnel inferior opening was (15.2 ± 7.4) mm. The hepatic short vessels were distributed along the middle and lower 1/3 of hepatic inferior vena cava (HIVC), with a slight predominance on its left wall. A few hepatic short vessels were distributed along the upper 1/3 of the HIVC. We concluded: the anatomy of the retrohepatic tunnel provides a basis for use of LHM in liver surgery; more hepatic short vessels from hepatic caudate lobe can be preserved via right approach. The retrohepatic tunnel can be used as a good surgical approach in liver surgery; its application also has important significance in laparoscopic minimally invasive liver surgery.
肝后隧道操作（LHM）是肝脏外科的一项重要技术。然而，中国人群肝脏外科入路肝后隧道的应用解剖仍需进一步研究。本研究通过对 32 例福尔马林固定尸体进行解剖，测量相关参数，探讨其在国人中的基本解剖及其临床应用。结果显示，肝后隧道的长度为（60.6±9.9）mm，肝后隧道上开口宽度为（13.8±3.9）mm，肝后隧道下开口宽度为（15.2±7.4）mm。肝短静脉分布于肝下腔静脉（HIVC）中下 1/3 段，以左壁稍多，少数分布于 HIVC 中上 1/3 段。结论：肝后隧道的解剖为 LHM 在肝脏外科中的应用提供了解剖学基础，右入路可保留更多来自肝尾状叶的肝短静脉。肝后隧道可作为肝脏外科的一种良好手术入路，其在腹腔镜微创肝脏外科中的应用也具有重要意义。
