关键词: 腹腔镜, 肝切除, 肝门阻断, 应用解剖

Abstract:

Objective　To provide anatomic basis of hepatic vascular control in laparoscopic hepatectomy(LH) and design safe and convenient operative approach for vascular control.　Methods　 Antiseptic adult liver specimens were used in this study. Hepatic pedicle, hepatic artery, portal vein and hepatic vein were dissected. The length and angle of these vessels were recorded. Additionally, videos of LH were observed for identifying those structures.　Results　The plane of hepatic artery was lower than bile duct for 90% specimens. The site of portal bifurcation was always behind hepatic artery and bile duct. The left hepatic veins had common trunk with middle hepatic veins for most of specimens. A gap existed between the right hepatic vein and common trunk of left and middle hepatic vein, which filled by connective tissue and communicated with anterior surface of the retrohepatic inferior vena cava (IVC). The short hepatic veins located in the left and right borders of IVC. The number of the short hepatic veins was about 7±3. IVC ligament was a broad membranous connective tissue bridging the left and right side edges of the caval groove in which the IVC was embedded. This ligament was more easy to be identify in fresh specimens. The length and angles of each vessel was enough to be separated to keep space for hepatic vascular blocking during LH procedure.　Conclusions　Anatomic features of hepatic hilum area are helpful for vascular control performed in LH surgery.

Key words: Laparoscopy, Hepatectomy, Vascular control, Applied anatomy