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右肝胆道系统的罕见解剖变异。

Rare anatomic variations of the right hepatic biliary system.

作者信息

Garg Shallu, Kumar Hemanth, Sahni Daisy, Yadav T D, Aggarwal Anjali, Gupta Tulika

机构信息

Department of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.

Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Surg Radiol Anat. 2019 Sep;41(9):1087-1092. doi: 10.1007/s00276-019-02260-5. Epub 2019 May 21.

DOI:10.1007/s00276-019-02260-5
PMID:31115596
Abstract

PURPOSE

To report rare and clinically significant anatomic variations in the biliary drainage of right hepatic lobe.

METHODS

Unique variations in the extra- and intrahepatic biliary drainage of right hepatic lobe were observed in 6 cadaveric livers during dissection on 100 formalin-fixed en bloc cadaveric livers.

RESULTS

There was presence of aberrant drainage of right segmental and sectorial ducts in four cases and of accessory right posterior sectorial duct in two cases.

CONCLUSIONS

We encountered some extensively complicated biliary drainage of right hepatic lobe, unsuccessful recognition of which can lead to serious biliary complications during hepatobiliary surgeries and biliary interventions.

摘要

目的

报告右肝叶胆汁引流罕见且具有临床意义的解剖变异。

方法

在对100具福尔马林固定的整体尸体肝脏进行解剖时,在6具尸体肝脏中观察到右肝叶肝外和肝内胆汁引流的独特变异。

结果

4例存在右段和扇形胆管的异常引流,2例存在副右后扇形胆管。

结论

我们遇到了一些右肝叶极其复杂的胆汁引流情况,未能识别这些情况可能导致肝胆手术和胆道介入期间出现严重的胆道并发症。

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本文引用的文献

1
Preoperative evaluation of accessory hepatic ducts by drip infusion cholangiography with CT.通过CT滴注胆管造影术对副肝管进行术前评估。
BMC Surg. 2017 May 8;17(1):52. doi: 10.1186/s12893-017-0251-9.
2
Preoperative detection and handling of aberrant right posterior sectoral hepatic duct during laparoscopic cholecystectomy.腹腔镜胆囊切除术中异常右后肝段胆管的术前检测与处理
J Hepatobiliary Pancreat Sci. 2015 Jul;22(7):558-62. doi: 10.1002/jhbp.252. Epub 2015 Apr 16.
3
Concepts for Liver Segment Classification: Neither Old Ones nor New Ones, but a Comprehensive One.
肝脏段分类的概念:非旧非新,而是一个综合概念。
J Clin Imaging Sci. 2013 Oct 29;3:48. doi: 10.4103/2156-7514.120803.
4
What is the duct of Luschka?--A systematic review.卢什卡氏管是什么?——系统综述。
J Gastrointest Surg. 2012 Mar;16(3):656-62. doi: 10.1007/s11605-011-1802-5. Epub 2012 Jan 4.
5
Management of bile duct injury after laparoscopic cholecystectomy: a review.腹腔镜胆囊切除术后胆管损伤的处理:综述
ANZ J Surg. 2010 Jan;80(1-2):75-81. doi: 10.1111/j.1445-2197.2009.05205.x.
6
Embryology of extra- and intrahepatic bile ducts, the ductal plate.肝外和肝内胆管的胚胎学,导管板
Anat Rec (Hoboken). 2008 Jun;291(6):628-35. doi: 10.1002/ar.20710.
7
Vascular and biliary variants in the liver: implications for liver surgery.肝脏中的血管和胆管变异:对肝脏手术的影响。
Radiographics. 2008 Mar-Apr;28(2):359-78. doi: 10.1148/rg.282075099.
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Relationship between right portal and biliary systems based on reclassification of the liver.
Am J Surg. 2007 Jan;193(1):1-4. doi: 10.1016/j.amjsurg.2006.10.007.
9
Bile leaks from the duct of Luschka (subvesical duct): a review.来自卢施卡管(膀胱下导管)的胆汁漏:综述
Langenbecks Arch Surg. 2006 Sep;391(5):441-7. doi: 10.1007/s00423-006-0078-9. Epub 2006 Aug 23.
10
Types and frequencies of biliary tract variations associated with a major portal venous anomaly: analysis with multi-detector row CT cholangiography.与主要门静脉异常相关的胆道变异类型及频率:多层螺旋CT胆管造影分析
Radiology. 2006 Jan;238(1):156-66. doi: 10.1148/radiol.2381041783.