幼猪辅助性部分肝移植供肝体外解剖学观察及其修整分割

目的体外观察幼猪供肝的解剖学特点,总结辅助性部分肝移植供肝修整分割经验。方法16头幼猪供肝灌洗取出后于体外进行解剖学观察,借用探针条探查肝动脉和胆管,用刮扒水洗法切除左半肝,断面管道仔细结扎,余下右半肝作为供肝。结果幼猪肝脏质地脆嫩,分为左外侧叶、左中叶、右中叶、右外侧叶和尾状叶等5叶。其各部分体积、质量与其体质量呈正相关。肝中裂较浅,但其间少有门静脉交通支存在。肝固有动脉可有变异。肝静脉均于肝内汇入下腔静脉,左半肝回流静脉多有共干（14/16）。肝上、肝下下腔静脉均短,肝内下腔静脉下段肝实质较薄。16例供肝修整分割均顺利完成,断面管道显露清晰,复流后充盈良好,肝断面出血少。结论根据幼猪体重可估计其肝脏各部体积和质量;刮扒水洗法行供肝体外分割简便实用;获得的右半肝作为供肝,其肝上下腔静脉易于与受体肝内下腔静脉端侧吻合。

Anatomic observation and dividing of the donor liver of young pigs in auxiliary partial liver transplantation

Objective To observe the anatomic characteristics of donor liver of young pigs and to summarize the experiences of liver dividing in vitro.MethodsThe donor livers of 16 young pigs were observed in vitro.Both the hepatic artery and bile duct were explored with probe.The left lobe of liver was resected in vitro with scraping and washing method,and the remnant right lobe was used as a graft.ResultsThe livers of young pigs were delicate and had 5 lobes.Both the liver volume(cm3) and weight(g) were positively correlated to its body weight(kg).The hepatic middle fissure was shallow,among which there was few communicating branch of portal vein.Some variation was found in hepatic proper artery.All hepatic veins converged into inferior vena caval(IVC) in the liver.Most hepatic veins of left lobe had co-trunks(14/16).Both the supra-and infra-hepatic IVC were short and the parenchyma surrounding intrahepatic IVC was thin.The trimming and dividing of 16 donor livers were successfully completed and various kinds of ducts were excellently disclosed.The donor livers were sufficiently engorged after reflow with little hemorrhage in the hepatic section.ConclusionThe liver volume and weight of young pig can be estimated by its body weight.The scraping and washing method is simple and useful in the dividing of donor liver in vitro.As donor liver,the suprahepatic IVC of right lobe can be conveniently end-to-side anastomosed to the intrahepatic IVC of the host.