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目的探讨肝后下腔静脉(RHIVC)前间隙和肝外进、出肝血管在半肝切除术中的临床解剖学意义。方法对21例通过RHIVC前间隙解剖与选择肿瘤侧半肝进、出血管解剖阻断技术(slective hepatic vascul exclusi,SHVE)和22例Pringle阻断法的半肝切除术,同时对半肝切除一侧RHIVC的肝短静脉(shorthepatic veins SHVs)数目和分布情况进行分析。结果在SHVE组患者解剖RHIVC前间隙和将肿瘤侧肝动脉、肝门静脉、肝静脉解剖分离予以结扎或置阻断带过程顺利,无发生RHIVC或肝静脉损伤。在本组43例半肝切除术中,SHVs数量3～4支44.2%,6～8支55.8%,其中SHVs位于RHIVC前壁中轴线占11.6%。结论由于RHIVC前间隙无/或潜在少,且细小的SHVs,通过RHIVC前间隙解剖与SHVE技术,对于巨大肝肿瘤的半肝切除术具有重要的临床实用意义。
Objective To investigate the clinical anatomic significance of prehepatic inferior vena cava (RHIVC) anterior gap and extrahepatic extrahepatic and hepatic vessels in hemihepatectomy. Methods Twenty-one patients undergoing partial hepatectomy with RHEMC anterior dissection and selective hemivertebra resection with slective hepatic vascul exclusi (SHVE) and 22 patients with Pringle blockade The number and distribution of shorthepatic veins SHVs in the lateral RHIVC were analyzed. Results In the SHVE group, the anterior dissection of RHIVC and the dissection of hepatic artery, hepatic portal vein and hepatic vein in the side of the RHIVC were ligation or occlusion, and no RHIVC or hepatic vein injury occurred. In the group of 43 cases, the number of SHVs was 44.2% with 3-4 branches and 55.8% with 6-8 branches. The SHVs were located in 11.6% of the anterior wall of RHIVC. Conclusion Due to the lack of / or potential for small anterior gap in RHIVC and the small size of SHVs, RHIVC anterior gap dissection and SHVE technique are of great clinical practical significance for hemihepatectomy of giant liver tumors.