腹腔镜肝尾状叶切除术的应用解剖学研究

发布时间：2018-07-05 08:27

本文选题：腹腔镜 + 肝切除术　；参考：《第一军医大学》2006年博士论文

【摘要】：由于腹腔镜肝尾状叶切除术是技术复杂、难度极大的一种手术，目前仍处于探索、研究阶段，还未有腹腔镜下肝尾状叶切除术的临床报道。本研究试图通过应用解剖学、影像学、动物实验及临床肝切除的研究来探讨腹腔镜下肝尾状叶切除术的可能性。第一章肝尾状叶的应用解剖学研究目的：为肝尾状叶切除术提供形态学理论基础。方法：选取37具成人离体尸肝标本，采用雕琢法观测肝尾状叶形态、毗邻及管道、尾状叶静脉系统属支、走行，肝后腔静脉前间隙。根据三管系统分界尾状叶边界。结果： 1．位置及形态毗邻：肝尾状叶位于第一、二、三肝门之间，可分为三部分，Spiegel叶、腔静脉旁部及尾状突；尾状叶的Spiegel叶与腔静脉旁部存在较为明显的界线，其外部标志大致与其外切迹相当，腔静脉旁部与尾状突无明显的界线。肝尾状叶有三个游离面和二个肝内界面，即尾状叶左侧平面，其正对第二肝段：背侧平面，，正对后腹壁及右侧肾上腺；肝门平面，与肝蒂相邻；腹侧平面与第四肝段及／或第八肝段相邻；右侧界面邻近下腔静脉、第七肝段和第八肝段。后两个界面不能在外部看到，且形状不规则，存在较大的解剖学变异。
[Abstract]:Because laparoscopic caudate lobectomy is a complicated and difficult operation, it is still in the exploration stage and there is no clinical report of laparoscopic caudate lobectomy. This study attempts to explore the possibility of laparoscopic caudate lobectomy through applied anatomy, imaging, animal experiments and clinical hepatectomy. Chapter I Applied Anatomy of caudate lobe of liver objective: to provide a morphological basis for caudate lobectomy. Methods: 37 adult cadaveric liver specimens were used to observe the shape of caudate lobes adjacent to and conduit of caudate lobes and the branches of caudate lobular vein system were used to observe the anterior space of posterior hepatic vena cava. According to the three tube system boundary caudate leaf boundary. Results: 1. Location and morphology: the caudate lobe of the liver was located between the first, second and third hepatic hilus, and could be divided into three parts: Spiegel lobe, paracaval part and caudate process. The Spiegel lobe of caudate lobe has obvious boundary with paraventral vena cava, and its external marker is approximately the same as its external incisor, but there is no obvious boundary between paravicular part of vena cava and caudate process. The caudate lobe of the liver has three free surfaces and two intrahepatic interfaces, namely, the left plane of the caudate lobe, which is opposite to the second segment of the liver: the dorsal plane, the posterior abdominal wall and the right adrenal gland, and the hepatic hilar plane, adjacent to the hepatic pedicle. The ventral plane is adjacent to the fourth segment and / or the eighth segment, and the right interface is adjacent to the inferior vena cava, the seventh segment and the eighth segment. The latter two interfaces can not be seen outside, and the shape of irregular, there is a large anatomical variation.
【学位授予单位】：第一军医大学
【学位级别】：博士
【学位授予年份】：2006
【分类号】：R657.3;R322

【相似文献】