Vasconcelos-Filho José-Olímpio M, Pereira Adamastor H, Pitta Guilherme B B, Leitão-Batista Laécio, Castro Aldemar A, Souza-Leão Alberto Ribeiro, Lacerda Cláudio M
Department of Surgery of the Oswaldo Cruz Hospital, University of Pernambuco, Rua Arnóbio Marques, 310, Recife, PE, CEP 50100-130, Brazil.
Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
Surg Radiol Anat. 2018 Apr;40(4):395-400. doi: 10.1007/s00276-017-1909-9. Epub 2017 Sep 9.
To measure the distance between the right and middle hepatic veins and portal vein branches, in human cirrhotic liver casts. Was this measure actually smaller in the cirrhotic liver than in normal one?
This study was authorized by an area Research Ethics Committee, and each study subject or legal representative granted signed informed consent. Acrylic corrosion casts of 21 resected cirrhotic livers were generated. Diameters of hepatic veins and portal branches and pertinent intervening distances were measured. To assess differences in estimated average (relative to reference values), Student's t test for one sample was applied.
Mean distances from right hepatic vein to the right portal branch and to portal vein bifurcation were 33 ± 6.4 and 36 ± 7.4 mm, respectively, both significantly less than published reference values in healthy human livers (p < 0.0001 and p < 0.0002, respectively). Mean distances from middle hepatic vein to right and left branches of portal vein were 36 ± 6.8 and 26 ± 8.8 mm, respectively.
Distances separating right hepatic vein and portal vein (right branch and bifurcation) are diminished in cirrhotic livers compared to healthy ones. Given its caliber and proximity to portal branches, the middle hepatic vein remains as a reasonable alternative for TIPS procedures.
测量人类肝硬化肝脏铸型中右肝静脉与肝中静脉及门静脉分支之间的距离。肝硬化肝脏中的这一测量值是否实际上比正常肝脏中的更小？
本研究经地区研究伦理委员会批准，每位研究对象或其法定代表人签署了知情同意书。制作了21个切除的肝硬化肝脏的丙烯酸腐蚀铸型。测量了肝静脉和门静脉分支的直径以及相关的中间距离。为评估估计平均值（相对于参考值）的差异，应用了单样本t检验。
右肝静脉到右门静脉分支和门静脉分叉的平均距离分别为33±6.4和36±7.4毫米，均显著小于健康人肝脏中已发表的参考值（分别为p<0.0001和p<0.0002）。肝中静脉到门静脉右支和左支的平均距离分别为36±6.8和26±8.8毫米。
与健康肝脏相比，肝硬化肝脏中右肝静脉与门静脉（右支和分叉处）之间的距离减小。鉴于其管径以及与门静脉分支的接近程度，肝中静脉仍是经颈静脉肝内门体分流术（TIPS）的合理替代选择。
