Dawson D L, Molina M E, Scott-Conner C E
Am Surg. 1986 May;52(5):253-6.
Partial splenectomy is possible because of vascular segmentation of this organ. Although interest has focused upon arterial supply, this study shows similar venous segmentation. Emerging splenic veins in excess of 1.7 mm at the hilum of ten unembalmed spleens were injected with different colors of modified Batson's compound, and corrosion casts were made. In four additional spleens, alternate veins and arteries were injected. Ten spleens had two primary segments (lobes); four had three lobes. Half of these lobes were further subdivided into two segments. Lobes and segments extended through the full thickness of the spleen. Relatively avascular interlobar planes were always approximately perpendicular to the longitudinal axis of the spleen, whereas intersegmental planes were more variable. Both interlobar and intersegmental planes frequently corresponded to marginal notches. When arteries and veins were both injected, similar segmentation was noted. Venous drainage did not overlap arterial segments, indicating that veins are intrasegmental. These results indicate that the surgical unit of the spleen can be based upon surgically accessible vessels at the hilum of the spleen. Identification of segmental vessels could permit salvage of a larger amount of splenic tissue than would be possible if only lobar vessels were identified.
由于脾脏的血管分段,部分脾切除术是可行的。尽管人们的兴趣主要集中在动脉供应上,但本研究显示了类似的静脉分段。对10个未防腐处理的脾脏脾门处直径超过1.7 mm的脾静脉分支注射不同颜色的改良巴特森氏化合物,并制作腐蚀铸型。另外对4个脾脏的静脉和动脉交替进行注射。10个脾脏有两个主要段(叶);4个有三个叶。其中一半的叶进一步细分为两个段。叶和段贯穿脾脏的全层。相对无血管的叶间平面通常大致垂直于脾脏的纵轴,而段间平面则更具变异性。叶间平面和段间平面都常常与边缘切迹相对应。当动脉和静脉都被注射时,观察到类似的分段情况。静脉引流并不与动脉段重叠,这表明静脉是段内的。这些结果表明,脾脏的手术单位可以基于脾脏脾门处可手术触及的血管。识别段血管比仅识别叶血管能挽救更多的脾组织。