Anatomical study of right hepatic vein system based on three⁃dimensional visualization
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    Abstract:

    Objective:This study aims to develop a novel roadmap of right hepatic vein(RHV) tributaries for surgical planning based on three-dimensional(3D) visualization. Methods:3D simulated anatomical liver resection(ALR) of healthy participants who underwent contrast-enhanced computed tomography(CECT) of the upper abdomen from July 2018 to June 2021 in the First Affiliated Hospital of Nanjing Medical University were retrospectively reviewed. Liver volume,distributions of RHV and its tributaries,incidence of the inferior right hepatic vein(IRHV) were estimated. Results:Total 336 eligible participants were assessed,with a median age of 59(48~67)years. The total liver volume was 1 255.65(1 071.43~1 450.078)mL,which was significantly larger in males than in females(P < 0.05). The Person correlation analysis revealed a positive and weak correlation between the diameter of RHV and the liver volume(r=0.242,P < 0.05). 1(1~2)IRHV was detected in 44.6% of volunteers. A negative and poor correlation was noted between the standardized diameter of RHV and the incidence of IRHV(r=-0.109,P < 0.05). The diameter of RHV without IRHV was significantly larger than that of RHV with IRHV(P < 0.05),which were 7.95(6.51~10.40)mm and 9.33(7.37~11.23)mm,respectively. There were15.8% of the participants excluded,whose RHV was short and unable to be fully exposed on the transection plane. Virtual RHV-oriented ALR of 283 participants with normal RHV was assessed to develop the roadmap of RHV tributaries. Hepatic veins draining segment Ⅵ(V6)and segment Ⅶ(V7)were concentrated at 0.45(0.33~0.55)and 0.78(0.71~0.84)of the transection plane in virtual right posterior sectionectomy respectively,where the number of V6 was significantly more than that of V7(P < 0.05). Hepatic veins draining segment Ⅴ(V5)and segment Ⅷ(V8)were concentrated at 0.41(0.32~0.50)and 0.78(0.70~0.86)of that in simulated left trisectionectomy respectively,where the number of V5 was significantly more than that of V8(P < 0.05). The diameter of V6 was significantly larger than that of V5(P < 0.05). Conclusion:Virtual roadmap of RHV tributaries is of great significance to guide precise anatomical liver resection.

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张飞鸿,季顾惟,许正刚,孙东伟,范 烨,谭忠明,武正山,陆 峰,王 科.基于三维可视化技术的肝右静脉系统解剖研究[J].南京医科大学学报(自然科学版英文版),2022,42(5):659-665.

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  • Received:March 23,2022
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  • Online: May 23,2022
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