| 肝动脉变异在肝门淋巴结廓清中的临床意义 |
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| 引用本文： | 霍明生, 鲁 正, 崔培元, 吴斌全, 吴 华, 吴 维, 许文青. 肝动脉变异在肝门淋巴结廓清中的临床意义[J]. 中国肿瘤临床, 2015, 42(1): 61-65. DOI: 10.3969/j.issn.1000-8179.20141159 |
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| 作者姓名： | 霍明生 鲁正 崔培元 吴斌全 吴华 吴维 许文青 |
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| 作者单位： | 作者单位:蚌埠医学院第一附属医院肝胆外科(安徽省蚌埠市233004) |
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| 摘 要： | 目的：探讨肝动脉变异在肝门淋巴结廓清中的识别与预防损伤策略。方法：回顾性分析2013年1 月至2014年7 月蚌埠医学院第一附属医院肝胆外科62例肝门淋巴结廓清中12例肝动脉变异患者术中处理情况。结果：12例肝动脉变异类型分为：MichelsⅢ型3 例（25.0%），MichelsⅥ型2 例（16.7%），MichelsⅨ型1 例（8.3%），Hiatt6 型1 例（8.3%），肝右动脉与肝总管空间位置变异2 例（16.7%），肝左右动脉共同起源于肝总动脉2 例（16.7%），以及肝右动脉起自胃十二指肠动脉1 例（8.3%）。 12例患者无肝动脉损伤；2 例发生术后并发症，其中1 例胰漏，另1 例切口感染；无术后出血、胆漏及肝脓肿等并发症发生。整体恢复良好。结论：在熟知各种肝动脉解剖变异类型的前提下，术前完善的影像学检查与评估，加以术中谨慎且精细的操作，将使肝动脉损伤明显减少。
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| 关 键 词： | 肝动脉变异 肝门淋巴结廓清 肠系膜上动脉 肝动脉损伤 |
| 收稿时间： | 2014-07-10 |
| 修稿时间： | 2014-09-20 |
Clinical significance of hepatic artery variation in hepatic portal lymphadenectomy |
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| Mingsheng HUO, Zheng LU, Peiyuan CUI, Binquan WU, Hua WU, Wei WU, Wenqing XU. Clinical significance of hepatic artery variation in hepatic portal lymphadenectomy[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2015, 42(1): 61-65. DOI: 10.3969/j.issn.1000-8179.20141159 |
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| Authors: | Mingsheng HUO Zheng LU Peiyuan CUI Binquan WU Hua WU Wei WU Wenqing XU |
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| Affiliation: | Department of Hepatobiliary Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu233004, China |
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| Abstract: | Objective:To investigate the recognition and injury prevention strategies of hepatic artery variations during hepatic portal lymphadenectomy. Methods:A retrospective analysis was performed, and12patients of hepatic arterial variation among 62pa -tients with hepatic portal lymphadenectomy were the subjects. The study was conducted in the First Affiliated Hospital of Bengbu Medi -cal College between January 2013and July 2014. The intraoperative treatment and postoperative complications were recorded. Results: Among12cases of hepatic artery variation, we found the following cases: 3 cases ( 25.0%) of Michels' Type III, 2 cases ( 16.7%) of Mi-chels' Type VI,1 case (8.3%) of Michels' Type IX, 1 case (8.3%) of Hiatt's Type6, 2 cases ( 16.7%) of spatial location variation between right hepatic artery and hepatic duct, 2 cases ( 16.7%) of left and right hepatic artery originating from a common hepatic artery, and1 case (8.3%) of right hepatic artery originating from the gastroduodenal artery. No injury of hepatic artery occurred. Two cases had post -operative complications, including 1 case of pancreatic leakage and 1 case of incision infection; postoperative hemorrhage, bile leakage, hepatic abscess did not occur in these two cases. Patients recovered well in general. Conclusion: Hepatic arterial injury can be signifi -cantly reduced by the following: increased familiarity with the various types of hepatic artery variations; complete imaging examina -tions for inspection and evaluation before surgery; and careful and meticulous operations in surgery. |
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| Keywords: | hepatic artery variation hepatic portal lymphadenectomy superior mesenteric artery hepatic arterial injury |
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