肝静脉的解剖分型及其研究进展

Anatomic Typing and Research Progress of Hepatic Vein

摘要: 当今国内肝癌发病率居高不下，肝切除术为其有效的治疗措施，在肝胆外科手术中，肝脏的血液回流是制约肝脏手术的重要因素，肝静脉作为肝脏血液重要的回流通路，因其解剖变异较大，术中可发生肝静脉损伤导致术后肝静脉引流不畅引发严重后果；同时21世纪外科手术的“精准性”变得愈发重要，在复杂肝切除术、肝移植术前充分了解肝静脉解剖分型是提升肝脏手术“精准性”的重要一环，所以术前充分了解肝静脉解剖分型的重要性不言而喻。肝静脉解剖走行及变异较复杂，按其解剖特点对其进行分型，有利于术者在肝脏手术术前充分了解并掌握患者肝静脉个体解剖情况及分型，为肝脏手术提供解剖学依据，其对手术方案的制订、手术的安全实施、最大限度保留正常肝组织、降低术后并发症的发生率也有着重要的意义。本文将回顾阐述目前主肝静脉、肝右静脉、肝中静脉、肝左静脉各自分型的研究进展。

Abstract: At present, the incidence of liver cancer in China remains high, and hepatectomy is an effective treatment. In hepatobiliary surgery, liver blood reflux is an important factor restricting liver sur-gery. Hepatic vein, as an important return pathway of liver blood, may be damaged during opera-tion, resulting in poor postoperative hepatic vein drainage and serious consequences due to its large anatomical variation. At the same time, the “accuracy” of surgical operations in the 21st cen-tury has become increasingly important. Fully understanding the anatomical classification of liver veins before complex hepatectomy and liver transplantation is an important part of improving the “accuracy” of liver surgery, so the importance of fully understanding the anatomical classification of liver veins before surgery is self-evident. The anatomical course and variation of hepatic veins are complicated, and the classification of hepatic veins according to their anatomical characteristics is helpful for surgeons to fully understand and master the individual anatomical status and classification of patients’ hepatic veins before liver surgery, and provide anatomical basis for liver surgery. It also plays an important role in the formulation of surgical plan, the safe operation, the maximum preservation of normal liver tissue and the reduction of the incidence of postoperative complications. This article will review the current research progress of the main hepatic vein, right hepatic vein, middle hepatic vein and left hepatic vein autotyping.