Huang Y H, Jiang X H, Yuan H, Zou H Y, Mao W
Department of General Surgery, the Ninth Hospital of Nanchang, Nanchang 330002, China.
Zhonghua Gan Zang Bing Za Zhi. 2022 Oct 20;30(10):1100-1106. doi: 10.3760/cma.j.cn501113-20210823-00423.
To explore the relationship between the hepatic caudate lobe boundary and the ductal system so as to guide the identification of the anatomical relationship during liver surgery. The specific parts were observed and the liver parenchyma was removed according to 41 cadaveric liver autopsy specimens. The critical relationship between the hepatic caudate lobe and other ducts was observed to explore the reticular duct structure. The plane formed by the hepatic hilar plate and Arantius ligament served as the boundary between the caudate lobe and other hepatic lobes. The caudate lobe hepatic portal vein was composed of numerous small branches from its left and right branches. The portal vein adjacent to the vena cava was mainly derived from the left branch, and to a lesser extent from the right branch. Blood was drained straight from the caudate lobe vein into the inferior vena cava via the short hepatic vein. There were three or four bile duct branches in the caudate lobe. The main source of arterial blood flow were the left and right branches of the hepatic artery. An avascular zone of loose connective tissue was found between the caudate lobe and the retrohepatic inferior vena cava. The hepatic caudate lobe is an independent lobe. During hepatic caudate lobe surgery, the plane formed by the hepatic hilar plate and Arantius ligament can serve as the boundary between the caudate lobe and other hepatic lobes and be used for anatomical site identification. The duct system of the caudate lobe's is complicated, but it also has its own distinct regularity.
探讨肝尾状叶边界与胆管系统的关系，以指导肝脏手术中解剖关系的识别。根据41例尸体肝脏解剖标本，观察特定部位并去除肝实质。观察肝尾状叶与其他胆管的关键关系，以探究网状胆管结构。肝门板和肝圆韧带形成的平面作为尾状叶与其他肝叶的边界。尾状叶肝门静脉由其左右分支的众多小分支组成。与腔静脉相邻的门静脉主要来自左支，较少来自右支。血液从尾状叶静脉经肝短静脉直接引流至下腔静脉。尾状叶有三到四个胆管分支。动脉血流的主要来源是肝动脉的左右分支。在尾状叶与肝后下腔静脉之间发现一个疏松结缔组织的无血管区。肝尾状叶是一个独立的叶。在肝尾状叶手术中，肝门板和肝圆韧带形成的平面可作为尾状叶与其他肝叶的边界，用于解剖部位的识别。尾状叶的胆管系统复杂，但也有其自身独特的规律。
