MUKAIYA Mitsuhiro Sapporo Medical University, Instructor, 医学部, 講師 (00253998)
MURAKAMI Gen Sapporo Medical University, Prof., 医学部, 教授 (30157747)
HIRATA Koichi Sapporo Medical University, Prof., 医学部, 教授 (50136959)
|Budget Amount *help
¥1,400,000 (Direct Cost : ¥1,400,000)
Fiscal Year 1999 : ¥500,000 (Direct Cost : ¥500,000)
Fiscal Year 1998 : ¥900,000 (Direct Cost : ¥900,000)
We describe the pattern of intrahepatic vessels ramification in the right surgical lobes of 197 livers by the method of dissection. Firstly, the right posterior segments could be identified based on the ramification patterns of the intrahepatic portal veins in 51.7% of the cases as follows.
1)The posterior sectorial trunk was simply divided into segmental portal branches VIRUS (P6) and segmental portal branches VII (P7) trunks, S6 and S7 were readily identified based on the territories of P6 and P7, respectively.
2) Although the posterior sectorial trunk was absent, both S6 and S7 were identifiable from the portal ramification pattern since either P6 and P7 formed a single trunk. The three hepatic veins (RHV, SHV, MHV) often did not aid the identification of the liver segments in the region. Consequently, the less than ideal combinations of irregular configurations of the portal and hepatic venous systems suggested that the right posterior segments cannot be conclusively identified anatomically in 30-40% of cases. Secondly, on the lower region of the right love, the RHV, SHV and MHV showed complementary venous drainage relationships. In the upper region of the right lobe various names have been given to the thick venous tributaries, we systematically classified these tributaries into 5 types of "right superior radicles" (RSR), according to their topographical relationships with the right superior portal branches (P7 and P8), RHV, MHV, SHVs and their tributaries. Our morphometric examination of the upper region revealed that the sizes of P7 and P8 increased or decreased simultaneously, and suggested that the RSRs played limited roles in venous return. Overall, the venous return did not seem to converge into a single particular vein, but was carried away by multiple superior veins: the RHV, MHV, SHVs and 5 RSRs.