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目的为活体肝移植(living donor liver transplantation,LDLT)提供副肝右静脉(accessory right hepatic vein,aRHV)的解剖学资料。方法选取50例无病变成人尸体肝脏标本,解剖aRHV和肝右静脉(right hepatic vein,RHV),观测统计aRHV的出现率、数量、管径、开口部位、引流范围及与RHV的关系。结果aRHV出现率为96.0%,其中,直径≥3.00mm和直径≥5.00mm的出现率分别为60.0%和32.0%;aRHV汇入下腔静脉(IVC)肝后段上、中、下份,分别为6.4%、17.0%和76.6%,其管径分别为(4.33±1.10)mm、(5.76±2.52)mm、(4.83±1.34)mm;汇入IVC肝后段下份的aRHV,其开口部位46.8%(22/47)位于8:00～9:00点位之间;引流Ⅵ段、Ⅶ段的aRHV,管径分别为(6.30±2.20)mm和(4.49±1.22)mm;aRHV直径与RHV管径呈负相关(P=0.022,r=-0.410)。结论aRHV出现率较高,以开口于IVC肝后段下份右后侧者居多,汇入IVC肝后段中份的aRHV管径最粗;较细小的aRHV主要引流肝Ⅶ段,而较粗大的aRHV则引流肝Ⅵ段或Ⅵ段和Ⅶ段;当RHV较小时,其出现较粗大aRHV的可能性较大,反之则小,LDLT术前掌握aRHV的解剖特点,有助于制定合理的手术方案。
Objective To provide anatomic data of accessory right hepatic vein (aRHV) for living donor liver transplantation (LDLT). Methods Fifty cases of adult cadaveric liver specimens were selected for dissection of aRHV and right hepatic vein (RHV). The incidence, number, diameter of the aRHV, the location of the opening, the drainage area and the relationship with RHV were observed. Results The incidence of aRHV was 96.0%, of which, the incidences of diameter≥3.00mm and diameter≥5.00mm were 60.0% and 32.0%, respectively. The aRHV was introduced into the upper and lower posterior segment of the inferior vena cava (IVC) (4.33 ± 1.10) mm, (5.76 ± 2.52) mm and (4.83 ± 1.34) mm, respectively. The aRHV introduced into the lower part of the IVC liver posterior segment was 6.4%, 17.0% and 76.6% 46.8% (22/47) were located between 8:00 am and 9:00 am. The aRHV of segments Ⅵ and Ⅶ were drained with diameters of (6.30 ± 2.20) mm and (4.49 ± 1.22) mm, respectively. The diameters of aRHV and RHV diameter was negatively correlated (P = 0.022, r = -0.410). Conclusions The incidence of aRHV is high, with the majority of aRHV in the middle part of the posterior segment of IVC. The aRHV has the largest diameter in the middle part of IVC. The smaller aRHV mainly leads to hepatic segment Ⅶ, Of aRHV drainage of the liver Ⅵ section or Ⅵ section and Ⅶ section; when the RHV is smaller, it is more likely to appear larger aRHV, and vice versa, LDLT grasp the anatomy of aRHV before surgery to help develop a reasonable operation Program.