活体造影法肝内胆管的解剖学研究及临床意义
Study of anatomy and variation of intrahepatic biliary ducts through cholangiography and its clinical significance
目的 通过经皮胆道直接造影,研究肝内胆管的解剖与变异的类型与分布。 方法 经皮胆道造影50例, 用20 ml注射器接体外引流管进行造影,胆管充分显影的状态下,旋转拍摄胆管,观察胆管解剖与变异。 结果 50例成像中胆管变异42.0%(21例)。12.0% (6例)显示右前叶肝管、右后叶肝管及肝左管呈三分叉状汇合形成肝总管。8.0% (4例) 肝左管先和右前叶肝管汇合,在肝门处与右后叶肝管汇合。20.0% (10例) 肝左管先和右后叶肝管汇合,在肝门处与右前叶肝管汇合。2.0% (1例)多个肝管在肝门处汇合。 结论 胆管解剖与变异的分析对术前手术方式的确定有一定的临床意义。
Objective To observe the anatomy of the bile ducts and its variation through revolving radiography of the bile ducts by percutaneous transhepatic cholangiography (PTC). Methods 50 cases of PTC were carried out with 20ml syringe connected to external drainage tube and the bile duct anatomy and the variation were observed by revolving radigography of the bile ducts at the fully developing status. Results The variation of the bile ducts was revealed in 21 of 50 cases, accouting 42%.In 6 cases, accounting for 12%, intrahepatic bile ducts of the right anterior lobe, intrahepatic bile ducts of the right posterior lobe and left bile ducts united to form the common bile duct; In 4 cases, accounting for 8.0%, the left bile ducts first converged with the intrahepatic bile ducts of the right anterior lobe, and then they converged with the intrahepatic bile ducts of the right posterior lobe at the hepatic portal; in 10 cases, accounting for 20.0%), the left bile ducts converged first with the intrahepatic bile ducts of the right posterior lobe, and then they converged with intrahepatic bile ducts of the right anterior lobe at the hepatic portal; in 1 case , accounting for 2.0% , multiple bile ducts formed the common bile duct at the hepatic portal. Conclusion Analysis of the bile duct anatomy and the variation holds a clinical significance on determination of the operative pattern.
Bile duct anatomy / Bile duct variation / Percutaneous transhepatic cholangiography
[1] 金武男,杨香. 螺旋CT三维重建对各肝段门静脉解剖结构的观察
[J]. 中国医学影像技术, 2003,19(6):692-695.
[2] 金武男,杨香. 门静脉的解剖与变异
[J]. 中国临床解剖学杂志,2006,24(2):157-159.
[3] 吴金术,毛先海,杨尽晖,等. 右肝管的缺如与医源性胆道损伤
[J]. 中华肝胆外科杂志, 2003, 9(12):733-735.
[4] Couinaud C.Surgica1 Anatomy of the 1iver revisited.C.Couinaud. Paris,1989.
[5] 金武男,杨香, 车成日. 螺旋CT三维重建对各肝段引流静脉的研究及其临床意义
[J].中国临床解剖学杂志, 2004, 22(2):193-195.
[6] 贺冠海,周吉林.肝管的应用解剖研究
[J]. 中国现代手术学杂志,2002,6(1):48-49.
[7] 高安賢一, 森山紀之, 村松幸男,他. 肝内門脈の脈乾構築の検討とその有用性について-経皮経肝的門脈造影法を用いた肝内門脈の分岐次数及び亜区域枝の新しい命名
[J]. 日消誌, 1984,81(1):56-65.
[8] 桑山美知子,竹内和男,鹤岡尚志,他. 超音波による肝門部門脈の分岐形態に関する検討ー主に異常分岐例についてー
[J].Jpn J Med Ultrasonics,1989,16(3):346-353.
/
〈 |
|
〉 |