摘要
肝静脉系统解剖结构的复杂性和变异多样性对肝胆外科手术具有关键性影响。肝静脉主支(肝右静脉、肝中静脉和肝左静脉)及其特殊分支(脐裂静脉、前裂静脉和肝短静脉等)在走行路径、引流区域和汇合方式等方面均存在一定的规律,这些解剖特征直接关系到手术方案的制定和手术效果的评价。在精准肝脏外科时代,对肝静脉解剖的深入理解已成为实施复杂肝切除术和亲体/劈离式肝移植手术的基础。肝静脉的解剖分型不仅影响术中出血控制和手术安全性,更关系到术后病人肝脏功能的恢复和长期预后。特别是在亲体肝移植和劈离式肝移植中,供肝静脉的解剖分型直接决定了流出道重建的方式和预后。对肝静脉解剖分型进行深入分析,有助于优化手术方案,提高手术精准性,降低并发症发生率,改善病人的疗效。
The complexity and diversity of the anatomical structure of the hepatic venous system have a crucial impact on liver and biliary surgical operations.The main trunks of the hepatic veins—right hepatic vein,middle hepatic vein and left hepatic vein—along with their specialized branches(including umbilical fissural vein,anterior fissural vein and short hepatic veins)exhibit consistent patterns in their courses,drainage territories,and confluences.These anatomical features directly influence surgical planning and outcomes evaluation.In the era of precision liver surgery,a profound understanding of hepatic venous anatomy has become fundamental for performing complex hepatectomies and living donor/split liver transplantation.The anatomical classification of hepatic veins not only affects intraoperative hemorrhage control and surgical safety but also determines postoperative functional recovery and long-term prognosis.Particularly in living donor and split liver transplantation,the anatomical classification of donor hepatic veins dictates the approach to outflow reconstruction and subsequent outcomes.In-depth analysis of hepatic venous anatomical classifications will optimize surgical strategies,enhance procedural precision,reduce complication rates,and improve patient prognosis.
作者
刘振宇
熊兴
张彤
LIU Zhen-yu;XIONG Xing;ZHANG Tong(Organ Transplantation Clinical Medical Center of Xiamen University,Department of General Surgery,Xiang'an Hospital of Xiamen University,School of Medicine,Organ Transplantation Institute of Xiamen University,Xiamen Human Organ Transplantation Quality Control Center,Xiamen Key Laboratory of Regeneration Medicine,Fujian Provincial Key Laboratory of Organ and Tissue Regeneration,School of Medicine,Xiamen University,Xiamen 361102,China)
出处
《中国实用外科杂志》
北大核心
2025年第8期945-951,共7页
Chinese Journal of Practical Surgery
基金
福建省自然科学基金面上项目(No.2024J0101-3)
厦门市卫生健康高质量发展科技计划医学创新课题(No.2024GZL-CX08)
厦门大学附属翔安医院科研启动基金项目(No.XAH23017)。
关键词
肝静脉
解剖分型
肝切除术
肝移植
精准外科
hepatic vein
anatomical classification
hepatectomy
liver transplantation
precision surgery
