绕肝提拉法肝后隧道的应用解剖学研究

目的通过解剖学的研究,探讨绕肝提拉法手术的临床解剖学依据。方法选用解剖教学的21例成人尸体的肝后下腔静脉,从腔内观察尸肝组汇入肝后下腔静脉的肝短静脉开口情况,按不同绕肝提拉法的路径和不同肝后隧道宽度(10mm、6mm)统计可能遇到的肝短静脉数。结果绕肝提拉法在肝后隧道宽度6mm时标准路径遇到肝短静脉0～3(中位数=1)支,标准右上方路径(EM路径,肝后下腔静脉右缘距肝下缘1cm)遇到肝短静脉0～2(中位数=0)支,后者小于前者,差异有统计学意义(P=0.003)。结论绕肝提拉法手术建立肝后隧道是可行且安全的。

Applied Anatomical and Experimental Study of Retrohepatic Tunnel of Liver Hanging Maneuver

Objective To study the clinical anatomical basis of the liver hanging maneuver through research of applied anatomy.Methods Retrohepatic portions of the inferior vena cava of 21 cadaver were observed intracavitarily,and the numbers of short hepatic vein(SHV)opening were counted based on different possible pathway of the liver hanging maneuver and different width of retrohepatic tunnel(10 mm,6 mm).Results The number of SHV was 0 to 3(median=1)using standard pathway of the liver hanging maneuver in 6 mm retrohepatic tunnel,and the number of SHV was 0 to 2(median=0)using EM pathway that was on the right border of retrohepatic portion of the inferior vena cava and 1 cm away from the inferior border of liver.There was a significant difference between the EM pathway and standard pathway,P=0.003.Conclusion The results show that setting up a retrohepatic tunnel through the liver hanging maneuver is feasible and safe.