Gao Yuan, Lu Yun
Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
Shandong Key Laboratory of Digital Medicine and Computer Assisted Surgery, Qingdao, China.
Gastroenterol Res Pract. 2018 Jun 6;2018:3573680. doi: 10.1155/2018/3573680. eCollection 2018.
Due to the increasing incidence of gastrointestinal (GI) tumors, more and more importance is attached to radical resection and patients' survival, which requires adequate extent of resection and radical lymph node dissection. Blood vessels around the gastrointestinal tract, as anatomical landmarks for tumor resection and lymph node dissection, play a key role in the successful surgery and curative treatment of gastrointestinal tumors. In the isolation of subpyloric area or hepatic flexure of the colon for gastrectomy or right hemicolectomy, lymph node dissection and ligation are often performed at the head of the pancreas and superior mesenteric vein, during which even a minor inadvertent error may lead to unwanted bleeding. Among these blood vessels, the venous system composed of Henle's trunk and its tributaries is the most complex, which has a direct influence on the outcome and postoperative recovery of the patients. There are many variations of Henle's trunk, with complicated courses and various locations, attracting more and more researchers to study it and tried to analyze the influence of its variations on gastrointestinal surgeries. We characterized various variants and tributaries of Henle's trunk using autopsy, vascular casting, 3D CT reconstruction, intraoperative anatomy, and Hisense CAS system and summarized and analyzed the tributaries of Henle's trunk, to determine its influence on GI surgeries.
由于胃肠道（GI）肿瘤的发病率不断上升，根治性切除和患者生存越来越受到重视，这需要足够的切除范围和根治性淋巴结清扫。胃肠道周围的血管作为肿瘤切除和淋巴结清扫的解剖标志，在胃肠道肿瘤的成功手术和根治性治疗中起着关键作用。在胃切除术或右半结肠切除术的幽门下区域或结肠肝曲分离过程中，淋巴结清扫和结扎通常在胰头和肠系膜上静脉处进行，在此期间，即使是轻微的疏忽错误也可能导致不必要的出血。在这些血管中，由亨勒干及其分支组成的静脉系统最为复杂，它直接影响患者的手术结果和术后恢复。亨勒干存在许多变异，其走行复杂且位置各异，吸引了越来越多的研究人员对其进行研究，并试图分析其变异对胃肠道手术的影响。我们通过尸检、血管铸型、三维CT重建、术中解剖以及海信CAS系统对亨勒干的各种变异和分支进行了特征描述，并对亨勒干的分支进行了总结和分析，以确定其对胃肠道手术的影响。
