An anatomical study on retrohepatic tunnel used for procedures of liver hanging maneuver
10.3760/cma.j.issn.1007-631X.2012.06.006
- VernacularTitle:绕肝提拉法“肝后隧道”建立的标准及解剖学依据
- Author:
Kunlun LUO
;
Zheng FANG
;
Hong LIU
;
Feng YU
;
Zhiqiang TIAN
;
Lei LU
- Publication Type:Journal Article
- Keywords:
Liver cirrhosis;
Vena cava,inferior;
Anatomy,regional;
Short hepatic veins
- From:
Chinese Journal of General Surgery
2012;27(6):452-455
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the anatomical basis of retrohepatic tunnel used for liver hanging maneuver.Methods The anatomy of inferior vena cava ( IVC ) was studied in 20 healthy adult cadavers and 15 patients with advanced cirrhosis who underwent piggyback liver transplantation to confirm the existence of the path of retrohepatic tunnel and count the number of short hepatic veins draining into retrohepatic IVC.Results Short hepatic veins mainly drain into the IVC on its left and right sides.The number of short hepatic veins that drain into the upper or middle portion of the IVC was significantly more than that into the lower portion ( x2 =48.524,P ＜ 0.01 ).On the path of retrohepatic tunnel,most short hepatic veins that drain into the IVC are located on the front side ( F =9.188,P ＜ 0.01 ).There was no significant difference in the number of short hepatic vein between the groups of liver cirrhosis and that of healthy adults ( t =0.405,P ＞ 0.05 ),but anatomic variation of post-hepatic tunnel is common in liver cirrhotics.Conclusions Retrohepatic tunnel was a potential space and had a unique anatomical feature.The establishment of retrohepatic tunnel by liver hanging maneuver is safe in noncirrhotics.However,in advanced posthepatitic cirrhosis,retrohepatic tunnel should be used with caution.
