Flament J B, Delattre J F, Palot J P, Ducasse A
Ann Gastroenterol Hepatol (Paris). 1985 Jan;21(1):3-11.
A precise knowledge of the sectorial anatomy of the liver and its variations is essential in order to be able to localize lesions in the parenchyma and to guide segmental resection of the liver. The hepatic systematization proposed by Couinaud and the nomenclature of the segments, which are numbered from I to VIII, are of obvious practical value and are used routinely by surgeons and radiologists. However, they do not take into account the exact position of the liver in the abdominal cavity. For this reason, we prefer to use a topographical nomenclature, based on J. Hureau's classification, consisting of a right posterior column, corresponding to Couinaud's right lateral sector (segments VI and VII), a right lateral column, corresponding to the right paramedian sector (segments V and VIII), a right paramedian column, corresponding to segment IV, a left lobe column, corresponding to segments III and II, and a dorsal sector corresponding to the caudate lobe or segment I. This nomenclature, which takes into account the position of the liver in the abdominal cavity, constitutes a compromise between the Anglo-Saxon nomenclature and Couinaud's segmental classification. It clearly emphasizes the posterior nature of the right lateral sector, the lateral position of the right para-median sector and the anterior position of the two sectors of the left lobe.
准确了解肝脏的分区解剖及其变异情况对于定位肝实质内的病变以及指导肝脏的节段性切除至关重要。Couinaud提出的肝脏系统化以及从I至VIII编号的肝段命名法具有明显的实用价值,外科医生和放射科医生经常使用。然而,它们没有考虑到肝脏在腹腔中的确切位置。因此,我们更倾向于使用基于J. Hureau分类的地形命名法,它包括一个右后柱,对应于Couinaud的右外侧区(VI和VII段);一个右侧柱,对应于右旁中区(V和VIII段);一个右旁中柱,对应于IV段;一个左叶柱,对应于III和II段;以及一个背侧区,对应于尾状叶或I段。这种命名法考虑到了肝脏在腹腔中的位置,是盎格鲁-撒克逊命名法和Couinaud节段分类法之间的一种折衷。它清楚地强调了右外侧区的后部性质、右旁中区的外侧位置以及左叶两个区的前部位置。