de Morais-Pinto Luciano, Pereira Vítor Pires, de Souza Vencato Marina, de Oliveira Alzido, Miglino Maria Angelica
Departamento de Morfologia, Universidade Federal de Santa Maria, Santa Maria, Brasil.
Faculdade de Medicina Veterinária, Universidade de Alfenas, Minas Gerais, Brasil.
Anat Histol Embryol. 2021 Mar;50(2):224-233. doi: 10.1111/ahe.12619. Epub 2020 Sep 22.
The external shape of the liver is varied and determines specific vascular arrangements. This morphological relationship is important to establish hepatic segmentation in different species submitted to surgeries that aim to preserve a larger area of liver parenchyma. After observing 60 livers injected with Neoprene Latex and three plastic moulds obtained by corrosion, eight hepatic venous segments were identified, drained by six hepatic veins agrouped into segmental veins, which drained one sector (segments I, VI, VII and VIII) and intersegmental veins, which drained more than one sector (segments II/III and IV/V). They were described as follows: left intersegmental vein, formed by a segmental vein from the papillary process (segment I), two to three lateral left segmental veins that drained the segment II, and one to five left paramedian segmental veins that drained the segment III; sagittal intersegmental vein, formed by the confluence between segmental vein of the quadrate lobe (segment IV) and the medial right paramedian segmental vein, which derived from the segment V; lateral right paramedian vein drained the dorsocranial sector of the segment VI; the lateral right segmental vein, formed by one to four vessels that drained segment VII, and the segmental vein of the caudate process, which drained the segment VIII. Understanding the number and disposition of the hepatic veins in lobate livers is essential to reduce bleeding risks in surgeries. The nomenclature based on segmentation analogy of non-lobate liver could be less confusing and, therefore, be more useful in the surgical approaches of lobate livers.
肝脏的外部形态各异，决定了特定的血管排列。这种形态学关系对于在旨在保留更大面积肝实质的手术中对不同物种进行肝段划分非常重要。在观察了60个注入氯丁橡胶乳胶的肝脏以及通过腐蚀获得的三个塑料铸型后，确定了八个肝静脉段，由六条肝静脉引流，这些肝静脉聚集成段静脉，引流一个扇区（I、VI、VII和VIII段），以及引流多个扇区的段间静脉（II/III和IV/V段）。它们的描述如下：左段间静脉，由乳头突（I段）的段静脉、两到三条引流II段的左外侧段静脉以及一到五条引流III段的左旁正中段静脉组成；矢状段间静脉，由方叶（IV段）的段静脉与源自V段的右内侧旁正中段静脉汇合而成；右外侧旁正中静脉引流VI段的背颅侧扇区；右外侧段静脉，由一到四条引流VII段的血管以及引流VIII段的尾状突段静脉组成。了解叶状肝脏中肝静脉的数量和分布对于降低手术中的出血风险至关重要。基于非叶状肝脏段划分类比的命名法可能不那么容易混淆，因此在叶状肝脏的手术入路中更有用。
