Distribution patterns of the right hepatic vein branches and their clinical significance in hepatic vein-guided anatomical hepatectomy
10.3760/cma.j.cn113884-20220930-00374
- VernacularTitle:肝右静脉分支的分布规律及其对循肝静脉解剖性肝切除术的临床意义
- Author:
Ziqiang GE
1
;
Xianhe ZHANG
;
Xinyu SUN
;
Yongbo YU
;
Qinyi LI
;
Zhidong WANG
Author Information
1. 哈尔滨医科大学附属第二医院肝胆外科，哈尔滨 150086
- Keywords:
Hepatectomy;
Right hepatic vein;
Three-dimensional reconstruction;
Hemorrhage
- From:
Chinese Journal of Hepatobiliary Surgery
2023;29(2):91-96
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To elucidate the spatial distribution patterns of the right hepatic vein by analyzing the image information obtained after CT three-dimension reconstruction of liver to provide guidance in surgical planning of anatomical hepatectomy.Methods:A retrospective analysis was performed on the clinical data of 77 subjects who underwent CT examination of the liver at the Second Affiliated Hospital of Harbin Medical University from September 2018 to October 2021. There were 42 males and 35 females, aged (50.2±12.8) years old. CT DICOM data of the patients were collected, and the two-dimensional image data were reconstructed into a three-dimensional model by using the 3D reconstruction software. The characteristics and typing were studied by analyzing the number of branches of the right hepatic vein and the spatial location of the main trunk.Results:Of 77 subjects, 645 branches of the right hepatic vein were observed in the liver CT 3D reconstruction model, including 268 (41.6%) right-sided branches, 240 (37.2%) dorsal branches, 70 (10.9%) left-sided branches, and 67 (10.3%) ventral branches. Each right hepatic vein possessed 3 (3, 4) right-sided branches, 3 (3, 4) dorsal branches, 1 (0, 1) left-sided branch, and 1 (0, 1) ventral branch. The numbers of branches in the four directions were significantly different ( H=175.89, P<0.001). Comparison showed that the number of right-sided branches was significantly more than that of the left-sided (χ 2=136.86) and ventral (χ 2=140.07), respectively. The number of dorsal branches was more than that of left-sided (χ 2=-123.36) and ventral (χ 2=126.57) branches, respectively. The differences were significant ( P<0.001). There were no significant differences between the number of ventral and left-sided branches, and between the dorsal and right-sided branches (all P>0.05). Conclusion:The right hepatic vein had fewer ventral and left-sided branches. It is relatively safe to dissect the right hepatic vein from the ventral or the left side during surgery. For resection of the central liver segments or segment VIII of the liver, it is reasonable to transect the liver along the left border of the right hepatic vein.
