Kawasaki S, Makuuchi M, Miyagawa S, Matsunami H, Hashikura Y, Ikegami T, Kakazu T, Hayashi K, Takayama T, Kawarazaki H
First Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Am J Surg. 1996 Feb;171(2):286-8. doi: 10.1016/S0002-9610(97)89570-0.
The important features of extended lateral segmentectomy to obtain a partial liver graft comprising the left lateral segment and the left half of the medial segment are described with special reference to anatomical variation of the hepatic venous system. Ramification patterns of the hepatic vein tributaries around the juncture of the major hepatic veins with the inferior vena cava are delineated before starting liver resection, using intraoperative ultrasound. The left medial vein draining the left part of the medial segment is recognized close to the confluence of the middle and left hepatic veins. This tributary flows into the left hepatic vein in the majority of cases, but sometimes into the middle hepatic vein. The liver transection line is established in order to obtain the graft, including the drainage area of the left medial vein. Intraoperative ultrasound is indispensable for identifying the left medial vein in extended lateral segmentectomy.
描述了扩大外侧段切除术的重要特征，该手术用于获取包含左外侧段和内侧段左半部分的部分肝移植，并特别参考了肝静脉系统的解剖变异。在开始肝切除术前，使用术中超声描绘主要肝静脉与下腔静脉交界处四周肝静脉分支的分布模式。引流内侧段左部的左内侧静脉通常在靠近中肝静脉和左肝静脉汇合处被识别。在大多数情况下，这条支流流入左肝静脉，但有时也流入中肝静脉。为了获取包含左内侧静脉引流区域的移植物，确定肝切断线。在扩大外侧段切除术中，术中超声对于识别左内侧静脉是必不可少的。
