Bekheit Mohamed, Bucur Petru O, Wartenberg Mylene, Vibert Eric
Department of Liver Surgery and Transplantation, AP-HP, Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, France; Inserm Unité 1193, Villejuif, France; Institute of Biomedical Sciences, Division of Applied Medicine, University of Aberdeen, Aberdeen, UK.
Department of Liver Surgery and Transplantation, AP-HP, Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, France; Inserm Unité 1193, Villejuif, France.
J Surg Res. 2017 Apr;210:223-230. doi: 10.1016/j.jss.2016.11.004. Epub 2016 Nov 9.
The knowledge of the anatomic features is imperative for successful modeling of the different surgical situations. This study aims to describe the anatomic features of the porcine using computerized tomography (CT) scan.
Thirty large, white, female pigs were included in this study. The CT image acquisition was performed in four-phase contrast study. Subsequently, analysis of the images was performed using syngo.via software (Siemens) to subtract mainly the hepatic artery and its branches. Analysis of the portal and hepatic veins division pattern was performed using the Myrian XP-Liver 1.14.1 software (Intrasense).
The mean total liver volume was 915 ± 159 mL. The largest sector in the liver was the right medial one representing around 28 ± 5.7% of the total liver volume. Next in order is the right lateral sector constituting around 24 ± 5%. Its volume is very close to the volume of the left medial sector, which represents around 22 ± 4.7% of the total liver volume. The caudate lobe represents around 8 ± 2% of the total liver volume.The portal vein did not show distinct right and left divisions rather than consecutive branches that come off the main trunk. The hepatic artery frequently trifurcates into left trunk that gives off the right gastric artery and the artery to the left lateral sector, the middle hepatic artery that supplies both the right and the left medial sectors and the right hepatic artery trunk that divides to give anterior branch to the right lateral lobe, branch to the right medial lobe, and at least a branch to the caudate lobe. Frequently, there is a posterior branch that crosses behind the portal vein to the right lateral lobe. The suprahepatic veins join the inferior vena cava in three distinct openings. There are communications between the suprahepatic veins that drain the adjacent sectors. The vein from the right lateral and the right medial sectors drains into a common trunk. The vein from the left lateral and from the left medial sectors drains into a common trunk. A separate opening is usually encountered draining the right medial sector. The caudate lobe drains separately into inferior vena cava caudal to the other veins.
Knowledge of the anatomic features of the porcine liver is crucial to the performance of a successful surgical procedure. We herein describe the CT-depicted anatomic features of the porcine liver.
了解解剖特征对于成功模拟不同手术情况至关重要。本研究旨在使用计算机断层扫描(CT)描述猪的解剖特征。
本研究纳入了30只大型白色雌性猪。CT图像采集在四期对比研究中进行。随后,使用syngo.via软件(西门子)对图像进行分析,主要减去肝动脉及其分支。使用Myrian XP-Liver 1.14.1软件(Intrasense)对门静脉和肝静脉的分支模式进行分析。
肝脏平均总体积为915±159毫升。肝脏中最大的叶是右中叶,约占肝脏总体积的28±5.7%。其次是右外侧叶,约占24±5%。其体积与左中叶非常接近,左中叶约占肝脏总体积的22±4.7%。尾状叶约占肝脏总体积的8±2%。门静脉没有明显的左右分支,而是从主干发出连续的分支。肝动脉常分为左干,发出胃右动脉和左外侧叶动脉;肝中动脉,供应右中叶和左中叶;肝右动脉干,分为右外侧叶前支、右中叶支和至少一支尾状叶支。通常有一支后支在门静脉后方穿过至右外侧叶。肝上静脉在三个不同的开口处汇入下腔静脉。引流相邻叶的肝上静脉之间存在交通。右外侧叶和右中叶的静脉汇入一个共同的主干。左外侧叶和左中叶的静脉汇入一个共同的主干。通常会遇到一个单独的开口引流右中叶。尾状叶分别汇入下腔静脉,位置在其他静脉的尾侧。
了解猪肝的解剖特征对于成功进行手术至关重要。我们在此描述了CT显示的猪肝解剖特征。