关键词: 胆囊静脉回流； ,  , 胆囊门静脉； ,  , 临床解剖学； ,  , 血管铸型； ,  , 胆囊癌血管转移

Abstract: Objective     To observe the reflux mode of cholecystic vein and the exact locations of venous confluence, so as to provide an anatomical understanding of the hematogenous metastasis in gallbladder carcinoma and surgical operation in laparoscopic cholecystectomy.    Methods    Thirty-two cases of fresh adult liver and gallbladder specimens were made into section specimens, in which the number of branches and tributaries of cholecystic vein were counted and the diameter of these vessels were measured. The patterns of reflux and the and the various locations of venous confluence were observed.  Results Normally, there were 2-4 chloeytic veins from the gallbladder. The average longitude the veins was about 1.6 (1.1-2.1) mm The average diameter of middle location was about 3.1(2.4-4.1) cm. The cholecystic vein had 3 (2-5) branches with a terminal diameter of 1.6 (0.8-2.8) mm.  There were 4 (3-5) branches of the cholecystic vein, with a diameter of 1.5 (0.8-2.2) mm at the beginning. About the various locations of cholecystic veins, it was observed in 10 cases that there was one single branch on both left and right side. Two branches on both sides were found in 6 cases, one branch on left side with two branches on right side were found in 7 cases, three branches on left side with one branch on right side in one single case.   The small tributaries of the cholecystic vein which arose from the body and fundus of the gallbladder were accompanied by the branches of the cholecystic artery, then went to both sides of the gallbladder, and formed 2-5 tributaries through 2-3 tiers of arcades, and merged into the cholecystic vein near the edge of the gallbladder bed. Further, the cholecystic vein g sent out 3-5 branches, ran 5~8 mm and anastomosed with the third to fifth tiers of the right branch of hepatic portal vein. At the bottom of the gallbladder bed, 3-5 small cholecystic veins anastomosed directly with the small branches of the right branch of the hepatic portal vein. Gallbladder jugular vein and the cholecystic duct met with the veins from the common bile duct or the hepatic duct, and went upward to flow into the right or left branch of the hepatic portal vein.    Conclusions    The veins from the body and fundus of the gallbladder anastomose with the right branch of the hepatic portal vein in the gallbladder portal vein pattern, that is, at first, the ends of the gallbladder capillary veins converges into venules, then each tributary merge into couple of cholecystic veins, and the cholecystic vein branches are divided into several tiers branches, which are anastomosed with the third to fifth tiers of the right hepatic portal vein.  

Key words: Venous reflux of cholecystic vein; ,  , Cholecystic portal vein; ,  , Clinical anatomy; ,  ,  Vascular cast; ,  , Vascular metastasis of gallbladder carcinoma