[Clinical significance of the relation of primary or secondary hepatic ducts and their surrounding vessels].
It is necessary that surgeons, who perform the operation on the primary and secondary hepatic ducts, should be familiar with the topography of these ducts and their surrounding vessels. A total of 22 "frame-specimens" of cadaveric liver (FSL) were built by the authors, from which the length of left and right hepatic ducts (LHD, RHD), right anterior lobe duct (RAD), the distance from the confluence of RAD and right posterior lobe duct (CAP) to the visceral surface of the liver, and the projection point of CAP on the diaphragmatic surface of Liver were all directly measured. The relationship between these proximal hepatic ducts and their surrounding vessels was also observed. Based on this study the authors proposed a new approach to incision of the whole length of LHD, RHD and RAD. The stenotic opening of right posterior lobe duct (RPD) can be exposed through the lumen of RHD. In 18.2% of 22 FSLs, the right posterior lobe artery was found in the lateral angle formed by RAD and RPD. To prevent the damage of this artery, which may cause intrahepatic hematoma, and its rupture into biliary tract, the cholongiotomy incision at the stenotic opening of RPD should be made within the lateral-superior quadrant of it close to the horizontal level.
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Wang
D000328:Adult; D001653:Bile Ducts, Intrahepatic / Q000033:anatomy & histology*; D002648:Child; D006499:Hepatic Artery / Q000033:anatomy & histology*; D006500:Hepatic Duct, Common / Q000033:anatomy & histology; D006503:Hepatic Veins / Q000033:anatomy & histology*; D006801:Humans; D008099:Liver / Q000033:anatomy & histology