肝管的应用解剖

在55例成人肝脏铸型和剥制标本上对肝内肝管进行了观察。以有无叶肝管参予左、右肝管的合成作为分型的依据。由规则的右前、后叶肝管合成的规则型右半肝管占49.09％。另50.91％为全部或部份不规则型的右肝管,其中有8例(14.55％)右前叶肝管或右后叶肝管分别单独汇入左肝管或总肝管。右肝管和右前叶肝管分别位于相应门静脉分支的前面和左侧,右后叶肝管绕右前叶门静脉根部上方向右行。由规则的左内、外叶肝管合成的规则型左肝管占32.73％,其余的为部份或全部不规则型的左肝管。左半肝的主要肝管位于门静脉主支(横部)的前方或(弯部、矢部的)内前方。此外,本文还就肝内主要肝管与临床应用的有关问题,进行了讨论。

The Applied Anatomy of Intrahepatic Ducts

The architectural arrangement of the intrahepatic ducts was studied on 55 specimens of normal adult liver. The right and left hepatic ducts could be categorized according to the pattern of their formation into regular and irregular types.The regular right hepatic duct formed by the union of the anterior and posterior lobar ducts was present in 27 cases (49.09%). The right anterior or right posterior lobar duct opened directly into the left hepatic duct or the common bile duct in 8 cases (14.55%). The right hepatic duct and the right anterior lobar duct were located on the anterior and sinister sides of the accompanying branches of the portal vein respectively. The right posterior lobar duct, after crossing superiorly over the root of the portal vein branch to the right anterior lobe, passed rightward.The regular left hepatic duct formed by the union of the left medial and left lateral lobar ducts was present in 18 cases (32.73%) . The main intrahepatic ducts of the left side of the liver were located on the anterior or ante-ro-medial side of the left branch of the portal vein.The problem concerning the architectural arrangement of the main intrahepatic ducts and its clinical significance was discussed.