摘要
目的探讨肝移植供肝动脉的解剖类型和避免变异肝动脉损伤的供肝切取及修整方法。方法回顾性分析2001年4月～2006年7月共计843例供肝切取和修整过程中肝动脉变异资料。结果在843例供肝中,肝动脉解剖总变异率为20.4%(172/843),其中发生频率最高的是变异肝右动脉来自肠系膜上动脉占6.67%(57/843),其次为肝左动脉来自胃左动脉占6.41%(54/843),来自腹腔干或胃十二指肠动脉占1.66%(14/843),变异肝右动脉来自腹腔干、肝总动脉或胃十二指肠动脉占1.54%(13/843),变异肝左动脉和变异肝右动脉同时存在占0.83%(7/843),肝总动脉来自肠系膜上动脉占1.54%(13/843),肝总动脉来自腹主动脉占0.95%(8/843)。结论肝动脉变异发生率较高,在供肝切取及修整过程中易受到损伤。熟悉肝动脉常见变异类型,并保持肠系膜上动脉主干和腹腔干的完整性是减少供肝变异肝动脉损伤的关键。
Objective To investigate the anatomical variations of donor hepatic artery and explore the measures that can be taken to avoid accidental hepatic artery injury during graft procurement and reconstruction. Methods The data of totally 843 consecutive patients undergoing orthotopic liver transplantation （OLT） during the period from April 2001 to July 2006 was reviewed in relation to anatomical variation of the donor hepatic arteries. The variations of the hepatic artery, the relationship between the anomalous hepatic artery and accidental injury of the hepatic artery were analyzed. Results In the 843 cases of OLT, the total anatomical variation rate of the donor hepatic arteries was 20.4% （172/843）. The common variations included replaced or accessory right hepatic arteries originated from superior mesenteric artery （6.67%, 57/843）, replaced or accessory left hepatic arteries originated from the left gastric artery （6.41%, 54/843） or from the celiac trunk and gastro-duodenal artery （1.66%, 14/843）, replaced or accessory right hepatic arteries originated from the celiac trunk, common hepatic artery and gastro-duodenal artery （1.54%,13/843）, replaced or accessory right hepatic arteries and left hepatic arteries coexistence （0.83%, 7/843）, variation of the common hepatic artery from the superior mesenteric artery （1.54%, 13/843） or from the abdominal aorta （0.95%, 8/843）. Conclusion During graft procurement and reconstruction, accidental injury of the hepatic artery is more likely in the presence of hepatic arterial variation, which can he a common clinical entity. Acquaintance with hepatic arterial variation and maintenance of the integrity of the superior mesenteric artery and celiac trunk are key to reducing potential hepatic artery injuries.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2007年第8期1164-1166,共3页
Journal of Southern Medical University
基金
科技部973计划(2003CB515500)
广东省科技计划项目(2004B35001003)
广东省自然科学基金团队项目(05200177)
广东省医学科研基金(A2002164)~~
关键词
肝移植
肝动脉
解剖变异
liver transplantation
hepatic artery
anatomic variation
