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为探讨肝右叶胆管手术的入肝途径和新的手术方法,解剖观察了40例成人肝剥制标体和3例肝铸型标本的Glisson系统。观测肝在管汇合类型及变异;肝右叶Ⅰ~Ⅲ级胆管的长度、管径及与主干夹角;Glisson系统三结构的位置关系。以胆囊切迹中点力基点对肝右叶内Ⅰ~Ⅲ级胆管始端作了肝的脏面、膈面三维投影定位。结果表明:行肝右叶胆管手术经脏面入路优于膈面;经投影点定位、穿刺、剖肝、找管的手术方法,具有定位准确、直现到达、操作简便、肝组织损伤小等优点。同时还讨论了其它临床问题。
In order to explore the path of liver entry and new operation of right lobe bile duct surgery, the Glisson system of 40 adult liver stripping bodies and 3 liver specimens were dissected. Observe the type and variation of liver confluence, the length and diameter of grade Ⅰ ~ Ⅲ bile ducts in the right hepatic lobe, and the angle between them with the trunk; the positional relationship among the three structures of Glisson system. The gallbladder notch midpoint of the base of the right lobe of the liver Ⅰ ~ Ⅲ grade bile duct at the beginning of the liver of the dirty surface, three-dimensional diaphragmatic projection. The results showed that: the right lobe of the liver bile duct surgeries are better than the diaphragmatic gland by the dorsal approach; the positioning method of the projection points, puncturing the liver, looking for the tube, accurate positioning, direct arrival, easy operation and small liver damage Etc. Other clinical issues are also discussed.