中国实用外科杂志

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腹腔镜肝右后区切除术中管道精细解剖与功能保留策略

蒋晨皓1,吴    柯1,张    彤2,郑  璐1   

  1. 1陆军军医大学第二附属医院肝胆胰外科,重庆 400037;2厦门大学附属翔安医院普通外科 器官移植中心,福建厦门 361102 
  • 出版日期:2025-08-01

  • Online:2025-08-01

摘要: 肝右后叶体积约占整个肝脏1/3,管道结构复杂且变异较多,涉及门静脉右后支主干向足侧发出的第一个分支、右肝静脉的属支类型、右后下静脉的解剖特征以及右后叶的毗邻关系等因素,在一定程度上增加了解剖识别和手术操作难度。通过合理的个体化术前规划和术中导航,可有效降低术中风险,最大限度保证切除精度并保留肝功能。腹腔镜下肝右后区精准切除为功能保留提供新的思路,也为优化个体治疗策略、改善病人预后带来潜在价值。

关键词: 腹腔镜, 肝切除, 精细解剖, 功能保留

Abstract: The right posterior lobe of the liver accounts for approximately 1/3 of the total liver volume, with a complex and highly variable ductal anatomy involving the first caudal branch arising from the main trunk of the posterior branch of the portal vein, the branching patterns of the tributaries of the right hepatic vein, the anatomical characteristics of the inferior right hepatic vein, and the anatomical adjacency of the right posterior lobe; these factors collectively increase the difficulty of anatomical identification and surgical manipulation. Through rational preoperative planning and intraoperative navigation, surgical risks can be effectively reduced, resection precision can be maximized, and liver function can be preserved. Laparoscopic precise resection of the right posterior region of the liver offers new insight into function-preserving and holds potential value for optimizing individualized treatment strategies and improving patient prognosis.

Key words: laparoscopy, liver resection, precise anatomy, functional preservation