Study on arterial distribution of extrahepatic bile duct by microvascular casting technique

XIAO Zhao-ming, LI Ze-yu, LIU Chang, MA Zi-wei, WU Kun-cheng, XU Guang-wei, LIANG Hai-bin, LUO Bao-hua, LUO Shi-wen, LUO Jian-heng, DAI Jing-xing, OUYANG Jun

Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (6) : 601-605.

Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (6) : 601-605. DOI: 10.13418/j.issn.1001-165x.2018.06.001

Study on arterial distribution of extrahepatic bile duct by microvascular casting technique

  • XIAO Zhao-ming, LI Ze-yu, LIU Chang, MA Zi-wei, WU Kun-cheng, XU Guang-wei, LIANG Hai-bin, LUO Bao-hua, LUO Shi-wen, LUO Jian-heng, DAI Jing-xing, OUYANG Jun
Author information +
History +

Abstract

Objective The micro-arterial cast specimens of extrahepatic bile duct were used to elucidate the source and distribution of extrahepatic bile duct blood supply and the characteristics of multiple annular vascular networks between the anastomosis artery chains of the upper duodenal bile duct, providing a clinical anatomical basis for biliary surgery. Methods Six cases of extrahepatic bile duct arteries were injected with acrylic resin as arterial filler. Photoshop was used to measure the inner diameter of small blood vessels. The blood supply source and distribution of extrahepatic bile duct were observed and analyzed.  Results  The left and right branches of the proper hepatic artery had arcuate communicating branches above the hepatic duct. There were abundant transverse arteries between the anastomotic artery chains at the left and right edges of the upper duodenal bile duct. The blood supply of anastomotic arterial chain was about 53% from the bottom, 46% from the top and 1% from the middle hepatic artery. Through the measurement of the diameter of the middle segment of each transverse artery and the initial diameter of both sides, it was found that the middle and upper segments of the  transverse arteries of the hepatic duct were larger, with an average middle diameter of (0.26±0.02)mm and(0.24±0.04)mm, respectively. The ratio of inner diameter of the upper segment to the middle segment was 1.09. The ratio of the middle segment to the middle segment was 1. The average inner diameter of the middle part of the lower segment was(0.14±0.03)mm. The ratio of inner diameter to both sides was 0.74. Conclusions The blood supply at the upper and lower ends is relatively balanced. In order to alleviate the injury of extrahepatic bile duct blood supply, a small longitudinal incision should be made in the upper part of the duodenum of the common bile duct and the lower part of the small common hepatic duct with less arterial anastomosis as far as possible. The blood supply of the common hepatic duct is abundant, supporting the current proposition that the isolated site of orthotopic liver transplantation is above the confluence of the gallbladder.

Key words

Extrahepatic bile duct /  Artery /  Microvascular casting technique /  Clinical anatomy

Cite this article

Download Citations
XIAO Zhao-ming, LI Ze-yu, LIU Chang, MA Zi-wei, WU Kun-cheng, XU Guang-wei, LIANG Hai-bin, LUO Bao-hua, LUO Shi-wen, LUO Jian-heng, DAI Jing-xing, OUYANG Jun. Study on arterial distribution of extrahepatic bile duct by microvascular casting technique[J]. Chinese Journal of Clinical Anatomy. 2018, 36(6): 601-605 https://doi.org/10.13418/j.issn.1001-165x.2018.06.001

References

[1]  史国恩. 胆管出血的原因诊断与治疗效果研究[J]. 实用心脑肺血管病杂志, 2017,25(S1):69-71.
[2]  李乾国, 任锐, 杜成友. 移植肝缺血型胆道病变的研究进展[J]. 中国全科医学, 2009,12(6): 516-518.
[3]  洪辉文, 吴坤成, 李泽宇, 等. 全身动脉铸型制作方法的改进[J]. 中国临床解剖学杂志, 2007,25(4): 478-479.
[4] Northover J, Terblanche J. Bile duct blood supply. Its importance in human liver transplantation[J]. Transplantation,1978,26(1): 67-69.
[5]  陈卫军, 应大君, 刘正津. 肝外胆道血供来源和分布及其临床意义[J]. 中国临床解剖学杂志,1994,12(4):248-251.
[6]  陈卫军, 应大君, 刘正津. 胆总管和肝总管的血供及其临床意义[J]. 中国临床解剖学杂志,1994,12(3):161-164.
[7]  陈卫军,应大君, 刘正津. 肝门区胆管的血供及其临床意义[J]. 中国临床解剖学杂志,1995,13(1): 8-10.
[8]  Tohma T, Cho A, Okazumi S, et al. Communicating arcade between the right and left hepatic arteries: evaluation with CT and angiography during temporary balloon occlusion of the right or left hepatic artery[J]. Radiology, 2005, 237(1): 361-365.
[9]  Gunji H, Cho A, Tohma T, et al. The blood supply of the hilar bile duct and its relationship to the communicating arcade located between the right and left hepatic arteries[J]. Am J Surg, 2006,192(3): 276-280.
[10] Cho A, Gunji H, Koike N, et al. Intersegmental arterial communication between the medial and left lateral segments of the liver[J]. Digest Surg, 2007, 24(5): 328-330.
[11] 霍胜军, 范松青, 谭善彰. 肝外胆管供血动脉在临床肝移植的应用解剖研究[J]. 中华器官移植杂志, 2005, 26(2):39-40.

Accesses

Citation

Detail

Sections
Recommended

/