霍明生, 鲁 正, 崔培元, 吴斌全, 吴 华, 吴 维, 许文青. 肝动脉变异在肝门淋巴结廓清中的临床意义[J]. 中国肿瘤临床, 2015, 42(1): 61-65. DOI: 10.3969/j.issn.1000-8179.20141159
引用本文: 霍明生, 鲁 正, 崔培元, 吴斌全, 吴 华, 吴 维, 许文青. 肝动脉变异在肝门淋巴结廓清中的临床意义[J]. 中国肿瘤临床, 2015, 42(1): 61-65. DOI: 10.3969/j.issn.1000-8179.20141159
Mingsheng HUO, Zheng LU, Peiyuan CUI, Binquan WU, Hua WU, Wei WU, Wenqing XU. Clinical significance of hepatic artery variation in hepatic portal lymphadenectomy[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2015, 42(1): 61-65. DOI: 10.3969/j.issn.1000-8179.20141159
Citation: Mingsheng HUO, Zheng LU, Peiyuan CUI, Binquan WU, Hua WU, Wei WU, Wenqing XU. Clinical significance of hepatic artery variation in hepatic portal lymphadenectomy[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2015, 42(1): 61-65. DOI: 10.3969/j.issn.1000-8179.20141159

肝动脉变异在肝门淋巴结廓清中的临床意义

Clinical significance of hepatic artery variation in hepatic portal lymphadenectomy

  • 摘要: 目的:探讨肝动脉变异在肝门淋巴结廓清中的识别与预防损伤策略。方法:回顾性分析2013年1 月至2014年7 月蚌埠医学院第一附属医院肝胆外科62例肝门淋巴结廓清中12例肝动脉变异患者术中处理情况。结果:12例肝动脉变异类型分为:MichelsⅢ型3 例(25.0%),MichelsⅥ型2 例(16.7%),MichelsⅨ型1 例(8.3%),Hiatt6 型1 例(8.3%),肝右动脉与肝总管空间位置变异2 例(16.7%),肝左右动脉共同起源于肝总动脉2 例(16.7%),以及肝右动脉起自胃十二指肠动脉1 例(8.3%)。 12例患者无肝动脉损伤;2 例发生术后并发症,其中1 例胰漏,另1 例切口感染;无术后出血、胆漏及肝脓肿等并发症发生。整体恢复良好。结论:在熟知各种肝动脉解剖变异类型的前提下,术前完善的影像学检查与评估,加以术中谨慎且精细的操作,将使肝动脉损伤明显减少。

     

    Abstract: Objective:To investigate the recognition and injury prevention strategies of hepatic artery variations during hepatic portal lymphadenectomy. Methods:A retrospective analysis was performed, and12patients of hepatic arterial variation among 62pa -tients with hepatic portal lymphadenectomy were the subjects. The study was conducted in the First Affiliated Hospital of Bengbu Medi -cal College between January 2013and July 2014. The intraoperative treatment and postoperative complications were recorded. Results: Among12cases of hepatic artery variation, we found the following cases: 3 cases ( 25.0%) of Michels' Type III, 2 cases ( 16.7%) of Mi-chels' Type VI,1 case (8.3%) of Michels' Type IX, 1 case (8.3%) of Hiatt's Type6, 2 cases ( 16.7%) of spatial location variation between right hepatic artery and hepatic duct, 2 cases ( 16.7%) of left and right hepatic artery originating from a common hepatic artery, and1 case (8.3%) of right hepatic artery originating from the gastroduodenal artery. No injury of hepatic artery occurred. Two cases had post -operative complications, including 1 case of pancreatic leakage and 1 case of incision infection; postoperative hemorrhage, bile leakage, hepatic abscess did not occur in these two cases. Patients recovered well in general. Conclusion: Hepatic arterial injury can be signifi -cantly reduced by the following: increased familiarity with the various types of hepatic artery variations; complete imaging examina -tions for inspection and evaluation before surgery; and careful and meticulous operations in surgery.

     

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