肝动脉解剖变异及其临床意义

CHINESEJOURNALOFCLINICALANATOMYVOL.29NO.220111,1,1,1,21.2.400016【】。74、。Hiatt77.02%57、、9.47%(7)1.35%(1)。6.76%(5)2.70%(2)2.70%(2),。3。。【】【】R323.3【】A【】1001-165X201102-174-05TheanatomicvariationsofhepaticarteryanditsclinicalcorrelationYINYong-fang,NIEShi-xin,TUZhi-tao,GUOLu,SUNShan-QuanDepartmentofAnatomy,ChongqingMedicalUniversity,Chongqing400016,China【Abstract】ObjectiveTosummarizethevariationsofthehepaticartery,andprovideanatomicbasisforclinicapplication.MethodsAtotalof74cadaverswerecollectedrandomlyforhisstudy.Theceliacarteryanditsbrancheswerecompletelyexposed.Thehepaticarterywereobservedandrecorded.ResultsReferringtoHiatt'ssixtypesofhepaticarterythreeofthemwereobserved:TypeI(n=57,77.02%),withthecommonhepaticarteryoriginatingfromtheceliacarterytoformthegastroduodenalandproperhepaticarteriesandtheproperarterydividingdistallyintoright,middleandleftbranches;TypeII(n=7,9.47%),withareplacedoraccessorylefthepaticarteryoriginatingfromleftgastricartery;TypeV(n=1,1.35%),withthecommonhepaticarteryoriginatingdirectlyfromsuperiormesentericartery.Besides,threeuncommontypeswerefound:TypeVII(n=5,6.76%),withareplacedlefthepaticarteryoriginatingfromcommonhepaticartery;TypeVIII(n=2,2.70%),withareplacedrighthepaticarteryoriginatingfromgastroduodenalartery;TypeIX(n=2,2.70%),withareplacedlefthepaticarterytogetherwiththegastricandesophagealbranchesoriginatingdirectlyfromceliacartery.ConclusionsThreeuncommonvarianttypesofhepaticarteryareobservedinoursmallsamples,whichindicatesthat,thevariationofthehepaticarteryiscomplexandoccasional,whichshouldbepaycloseattentiontothisfeatures.【Keywords】Hepaticartery;Anatomy;Variation;Classification【】2010-09-23【】09-2-061【】:1987-Tel[phone],E-mail:[e-mail]1988-Tel[phone],[e-mail]【】Tel[phone],[e-mail][1~8]。。[9,10]。。174、、。2741722.97%HiattI、II、VVII、VIII、IX1(1)I77.02%57CHACA··174··20112921HiattTab.1ComparisonofpresentresultwithHiatt’stypesTypeHiatt(%)n=1000(%)n=7475.777.02LHALGA9.79.47RHASMA10.60II、III2.30CHASMA1.51.35CHACA0.20*RLHACHA－6.76*RRHAGDA－2.70*CTCA－2.70*Hiatt6GDAPHALHA、MHA、RHA1。(2)II9.47%(7)CACHA、SALGA。LHACHAGDAPHARHA2。(3)V1.35%(1)CALGASACHASMACHALHA、RHALHARGA。SASMAAb3。1CHACAIFig.1TheCHAoriginatedfromtheCA(typeI)2RLHALGAIIFig.2TheRLHAoriginatedfromLGA(typeII)(4)VII6.76%(5)CHACARLHAGDAPHAPHAMHA、RHA4。(5)VIII2.70%(2)CALGA、SACHA。PHAGDA。PHARGALHA、MHARRHAGDA5。(6)IX2.70%(2)CHA、SACTCA。CTRLHAGb1、Gb2(Eb)。CHACAGDA、RGAPHA。MHA、RHA6。3、[9,10]。[10]1994200371111。Ishigami[9]84175··CHINESEJOURNALOFCLINICALANATOMYVOL.29NO.220112460。20.8%5/243.3%2/60P0.05。。。3.13CHASMAVFig.3TheCHAoriginateddirectlyfromSMA(typeV)4RLHACHAVIIFig.4TheRLHAoriginatedfromCHA(typeVII)5RRHAGDAVIIIFig.5TheRRHAoriginatedfromGDA(typeVIII)6CHA、SACTCAIXFig.6TheCHA、SAandCToriginatedfromCA(typeIX)176··2011292、、。。20.4%~42.2%[2~4,6,11]。1966Michels[1]。Michels[12][4]。7.88%6.50%8.42%。Hiatt[2]Michels6。Hiatt1P0.05。Hiatt、、、、。[13~15]n=744、5、IX6Hiatt。Hiattn=1000。。3.23.2.1[16][17]。[9]。2。。[18]。、、、。[8]。。[19]。。3.2.2TACE[6,20]。“”[6]。。[7]、。。[6]。。。Mu[21]。3。Hiatt10.6%[1,3,4,12]。。[20]。。、5。。【】[1]MichelsNA.Neweranatomyoftheliveranditsvariantbloodsupplyandcollateralcirculation[J].AmJSurg,1966,112(3):337-347.[2]HiattJR,GabbayJ,BusuttilRW.Surgicalanatomyofthehepaticarteries177··CHINESEJOURNALOFCLINICALANATOMYVOL.29NO.22011in1000cases[J].AnnSurg,1994,220(1):50-52.[3],.843[J].,2007,27(8):1164-1166.[4]Lopez-AndujarR,MoyaA,MontalvaE,etal.Lessonslearnedfromanatomicvariantsofthehepaticarteryin1,081transplantedlivers[J].LiverTranspl,2007,13(10):1401-1404.[5]DeSantisM,AriosiP,CaloGF,etal.Hepaticarterialvascularanatomyanditsvariants[J].RadiolMed,2000,100(3):145-151.[6],,,.[J].,2007,29(5):15-17.[7],.DSA[J].,2002,21(3):230-235.[8],,,.[J].,2001,10(2):97-99.[9]IshigamiK,ZhangY,RayhillS,etal.Doesvarianthepaticarteryanatomyinalivertransplantrecipientincreasetheriskofhepaticarterycomplicationsaftertransplantation[J]?AJRAmJRoentgenol,2004,183(6):1577-1584.[10],.[J].,2009,31(23):3261-3262.[11]XuX,ZhengSS.Variationsandreconstructionofthehepaticarteryinlivertransplantation[J].HepatobiliaryPancreatDisInt,2006,5(2):170-172.[12]CoveyAM,BrodyLA,MaluccioMA,etal.Varianthepaticarterialanatomyrevisited:digitalsubtractionangiographyperformedin600patients[J].Radiology,2002,224(2):542-547.[13].[J].,1995,13(4):263-267.[14]HiattJR,GabbayJ,BusuttilRW.Surgicalanatomyofthehepaticarteriesin1000cases[J].AnnSurg,1994,220(1):50-52.[15],.[M]//..,1986:14119·1708[16]LangnasAN,MarujoW,StrattaRJ,etal.Vascularcomplicationsafterorthotopiclivertransplantation[J].AmJSurg,1991,161(1):76-82,82-83.[17]WozneyP,ZajkoAB,BronKM,etal.Vascularcomplicationsafterlivertransplantation:a5-yearexperience.[J].AJRAmJRoentgenol,1986,147(4):657-663.[18].[J].,2006,10(6):401-403.[19],,,.[J].,2006,12(9):610-612.[20],,,.[J].,2007,4(2):126-128.[21]Muwei,Liqiang,Youjian,etal.Hepatocellularcarcinomafedbythehepaticarteryarisingfromthesuperiormesentericarteryangiographicanalysisandinterventionaltreatment[J].(),2003,2(3):176-178.11121.2.312000Leftascendingcervicalarteryoriginfromaorticarch:aca