Advances in clinical application of inferior right hepatic vein in hepatic surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YANG Yufei ¹ ,  XING Xue ²

1. Dalian Medical University, Dalian, Liaoning 116044, P. R. China;
2. Department of Hepatobiliary and Splenic Surgery, Qingdao Municipal Hospital, Qingdao, Shandong 266011, P. R. China;

Corresponding?author：

XING Xue, Email: xingxue1964@163.com

Keywords：

inferior right hepatic vein; hepatectomy; liver transplantation; Budd-Chiari syndrome

DOI：

10.7507/1007-9424.201809029

Video：

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Objective To summarize clinical applications of inferior right hepatic vein (IRHV) in liver surgery and to provide a basis for clinical applications of IRHV.Method The relevant literatures about clinical applications of IRHV in liver surgery in recent years were reviewed.Results As a kind of short hepatic veins, the IRHV directly flowed into the inferior vena cava, often accompanied by the portal vein of the segment Ⅵ. The occurrence rate of IRHV was 80%–90% by the autopsy examination, while which was 10%–30% by the imaging examination. The caliber of IRHV was 0.22–0.95 cm, and its caliber was negatively correlated with the caliber of right hepatic vein. The IRHV played a great role in the classification and treatment of the Budd-Chiari syndrome. According to the Couinaud liver classification method, the IRHV mainly drained the blood of segment Ⅵ. The existence of IRHV expanded the indications of hepatectomy. The reconstruction of IRHV in the liver transplantation could not only reserve the function of donor liver, but could compensatively drain the corresponding liver areas if the acute occlusion of other major hepatic veins happened.Conclusions IRHV has some important clinical significances in liver surgery. Fully studying course characters and adjacent relationship of IRHV can not only avoid injury during surgery, but also provide a new treatment idea for related liver diseases.

Citation： YANG Yufei, XING Xue. Advances in clinical application of inferior right hepatic vein in hepatic surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(3): 374-379. doi: 10.7507/1007-9424.201809029 Copy

1.	劉樹偉, 王懷經, 徐文香, 等. 肝右后靜脈的應用解剖. 中華外科雜志, 1991, 29(11): 708-710.
2.	王海全, 邢雪, 孫國鋒. 主肝靜脈和肝短靜脈的解剖學研究及其臨床意義. 中國普通外科雜志, 2007, 16(8): 767-769.
3.	Makuuchi M, Hasegawa H, Yamazaki S, et al. The inferior right hepatic vein: ultrasonic demonstration. Radiology, 1983, 148(1): 213-217.
4.	Fang CH, You JH, Lau WY, et al. Anatomical variations of hepatic veins: three-dimensional computed tomography scans of 200 subjects. World J Surg, 2012, 36(1): 120-124.
5.	Akgul E, Inal M, Binokay F, et al. The prevalence and variations of inferior right hepatic veins on contrast-enhanced helical CT scanning. Eur J Radiol, 2004, 52(1): 73-77.
6.	王莉, 薛雁山, 胡齊, 等. IRHV的CT影像解剖學研究及其臨床意義. 中國醫學影像學雜志, 2009, 17(1): 28-31.
7.	沈柏用, 施源. 肝臟分段解剖的新認識. 世界華人消化雜志, 2008, 16(9): 913-918.
8.	邢雪. 肝靜脈外科. 北京: 人民衛生出版社, 2005: 78-92.
9.	牛朝詩, 韓卉, 耿小平. 下腔靜脈與肝靜脈的外科應用解剖. 肝膽外科雜志, 1996, 4(1): 36-39.
10.	張我華, 孫善全. 肝靜脈口和下腔靜脈肝后段的應用解剖研究. 重慶醫學院學報, 1984, 9(3): 151-157.
11.	羅昆侖, 方征, 余鋒, 等. 肝后隧道手術高危區的解剖特點及臨床應用研究. 中國普通外科雜志, 2012, 21(1): 1-4.
12.	Zhang Y, Li Z, Liu S, et al. The study on sectional anatomy and imaging of accessory hepatic veins. Surg Radiol Anat, 2009, 31(10): 739-743.
13.	李林坤. 肝右后下靜脈 3.0 T 磁共振VIBE序列影像解剖學研究. 臨床放射學雜志, 2016, 35(8): 1199-1202.
14.	Champetier J, Haouari H, Le Bas JF, et al. Large inferior right hepatic vein. Clinical implications. Surg Radiol Anat, 1993, 15(1): 21-29.
15.	Nakamura S, Tsuzuki T. Surgical anatomy of the hepatic veins and the inferior vena cava. Surg Gynecol Obstet, 1981, 152(1): 43-50.
16.	趙靜, 楊廣奇, 沈靜嫻, 等. 64排螺旋CT血管成像評價肝靜脈解剖三維方位及變異. 中華消化病與影像雜志(電子版), 2013, 3(2): 19-23.
17.	Tani K, Shindoh J, Akamatsu N, et al. Venous drainage map of the liver for complex hepatobiliary surgery and liver transplantation. HPB (Oxford), 2016, 18(12): 1031-1038.
18.	Hanaoka J, Shimada M, Uchiyama H, et al. A simple formula to calculate the liver drainage volume of the accessory right hepatic vein using its diameter alone. Surgery, 2009, 146(2): 264-268.
19.	Cheng YF, Huang TL, Chen CL, et al. Variations of the middle and inferior right hepatic vein: application in hepatectomy. J Clin Ultrasound, 1997, 25(4): 175-182.
20.	Shilal P, Tuli A. Anatomical variations in the pattern of the right hepatic veins draining the posterior segment of the right lobe of the liver. J Clin Diagn Res, 2015, 9(3): AC08-AC12.
21.	De Cecchis L, Hribernik M, Ravnik D, et al. Anatomical variations in the pattern of the right hepatic veins: possibilities for type classification. J Anat, 2000, 197 Pt 3: 487-493.
22.	李虹璐, 喬英. 肝段下腔靜脈引流屬支的MSCT解剖及血管成像研究. 山西醫科大學, 2016.
23.	李杰, 李傳福. 肝右后下靜脈的超聲研究及臨床意義. 中國超聲醫學雜志, 1999, 15(11): 826-827.
24.	張彥, 李振平, 粱邦領, 等. 副肝靜脈的影像解剖學研究. 醫學影像學雜志, 2006, 16(2): 116-119.
25.	Ng YY, Finn JP, Hall-Craggs MA. Inferior right hepatic veins: MR assessment of prevalence and potential clinical significance in children. Pediatr Radiol, 1990, 20(8): 605-607.
26.	徐慧婷, 徐凱, 何鵬, 等. 肝臟三維容積超快速多期動態增強磁共振成像在布加綜合征副肝靜脈檢出中的應用價值. 中華肝臟病雜志, 2016, 24(8): 585-589.
27.	姚斐斐, 程敬亮, 楊子濤, 等. 3.0 T 非對比劑肝門靜脈磁共振血管成像技術研究. 中國醫學影像學雜志, 2013, 21(11): 853-856.
28.	祖茂衡, 徐浩, 顧玉明, 等. 副肝靜脈在Budd-Chiari綜合征診斷與治療中的價值. 中華放射學雜志, 1998, 32(9): 616-619.
29.	Fu YF, Wei N, Wu Q, et al. Use of accessory hepatic vein intervention in the treatment of Budd-Chiari syndrome. Cardiovasc Intervent Radiol, 2015, 38(6): 1508-1514.
30.	顧玉明, 祖茂衡, 徐浩, 等. 副肝靜脈成形術在Budd-Chiari綜合征治療中的應用. 中華放射學雜志, 2003, 37(1): 29-32.
31.	楊寧, 楊廣順. 原發性肝癌合并門靜脈高壓癥的診療現狀. 中華肝膽外科雜志, 2004, 10(10): 711-714.
32.	Hwang S, Lee SG, Park KM, et al. Quilt venoplasty using recipient saphenous vein graft for reconstruction of multiple short hepatic veins in right liver grafts. Liver Transpl, 2005, 11(1): 104-107.
33.	Makuuchi M, Hasegawa H, Yamazaki S, et al. Four new hepatectomy procedures for resection of the right hepatic vein and preservation of the inferior right hepatic vein. Surg Gynecol Obstet, 1987, 164(1): 68-72.
34.	Xing X, Li H, Liu WG. Hepatic segmentectomy combined with major hepatic vein resection for preserving remnant liver lobe. Hepatobiliary Pancreat Dis Int, 2008, 7(2): 165-168.
35.	Belghiti J, Guevara OA, Noun R, et al. Liver hanging maneuver: a safe approach to right hepatectomy without liver mobilization. J Am Coll Surg, 2001, 193(1): 109-111.
36.	彭淑牖, 曹利平, 李江濤, 等. 肝后隧道的建立與繞肝帶的使用在高難度肝切除術中的作用. 中華醫學雜志, 2003, 83(19): 1644-1647.
37.	Kwak BJ, Kim DG, Han JH, et al. Clinical outcome of 1 000 consecutive cases of liver transplantation: a single center experience. Ann Surg Treat Res, 2018, 95(5): 267-277.
38.	韋力, 李啟強, 彭民浩, 等. 肝靜脈、肝短靜脈注入下腔靜脈壁處在肝移植術中的應用. 中國局解手術學雜志, 1999, 8(3): 177-179.
39.	Ito K, Akamatsu N, Tani K, et al. Reconstruction of hepatic venous tributary in right liver living donor liver transplantation: The importance of the inferior right hepatic vein. Liver Transpl, 2016, 22(4): 410-419.

1. 劉樹偉, 王懷經, 徐文香, 等. 肝右后靜脈的應用解剖. 中華外科雜志, 1991, 29(11): 708-710.
2. 王海全, 邢雪, 孫國鋒. 主肝靜脈和肝短靜脈的解剖學研究及其臨床意義. 中國普通外科雜志, 2007, 16(8): 767-769.
3. Makuuchi M, Hasegawa H, Yamazaki S, et al. The inferior right hepatic vein: ultrasonic demonstration. Radiology, 1983, 148(1): 213-217.
4. Fang CH, You JH, Lau WY, et al. Anatomical variations of hepatic veins: three-dimensional computed tomography scans of 200 subjects. World J Surg, 2012, 36(1): 120-124.
5. Akgul E, Inal M, Binokay F, et al. The prevalence and variations of inferior right hepatic veins on contrast-enhanced helical CT scanning. Eur J Radiol, 2004, 52(1): 73-77.
6. 王莉, 薛雁山, 胡齊, 等. IRHV的CT影像解剖學研究及其臨床意義. 中國醫學影像學雜志, 2009, 17(1): 28-31.
7. 沈柏用, 施源. 肝臟分段解剖的新認識. 世界華人消化雜志, 2008, 16(9): 913-918.
8. 邢雪. 肝靜脈外科. 北京: 人民衛生出版社, 2005: 78-92.
9. 牛朝詩, 韓卉, 耿小平. 下腔靜脈與肝靜脈的外科應用解剖. 肝膽外科雜志, 1996, 4(1): 36-39.
10. 張我華, 孫善全. 肝靜脈口和下腔靜脈肝后段的應用解剖研究. 重慶醫學院學報, 1984, 9(3): 151-157.
11. 羅昆侖, 方征, 余鋒, 等. 肝后隧道手術高危區的解剖特點及臨床應用研究. 中國普通外科雜志, 2012, 21(1): 1-4.
12. Zhang Y, Li Z, Liu S, et al. The study on sectional anatomy and imaging of accessory hepatic veins. Surg Radiol Anat, 2009, 31(10): 739-743.
13. 李林坤. 肝右后下靜脈 3.0 T 磁共振VIBE序列影像解剖學研究. 臨床放射學雜志, 2016, 35(8): 1199-1202.
14. Champetier J, Haouari H, Le Bas JF, et al. Large inferior right hepatic vein. Clinical implications. Surg Radiol Anat, 1993, 15(1): 21-29.
15. Nakamura S, Tsuzuki T. Surgical anatomy of the hepatic veins and the inferior vena cava. Surg Gynecol Obstet, 1981, 152(1): 43-50.
16. 趙靜, 楊廣奇, 沈靜嫻, 等. 64排螺旋CT血管成像評價肝靜脈解剖三維方位及變異. 中華消化病與影像雜志(電子版), 2013, 3(2): 19-23.
17. Tani K, Shindoh J, Akamatsu N, et al. Venous drainage map of the liver for complex hepatobiliary surgery and liver transplantation. HPB (Oxford), 2016, 18(12): 1031-1038.
18. Hanaoka J, Shimada M, Uchiyama H, et al. A simple formula to calculate the liver drainage volume of the accessory right hepatic vein using its diameter alone. Surgery, 2009, 146(2): 264-268.
19. Cheng YF, Huang TL, Chen CL, et al. Variations of the middle and inferior right hepatic vein: application in hepatectomy. J Clin Ultrasound, 1997, 25(4): 175-182.
20. Shilal P, Tuli A. Anatomical variations in the pattern of the right hepatic veins draining the posterior segment of the right lobe of the liver. J Clin Diagn Res, 2015, 9(3): AC08-AC12.
21. De Cecchis L, Hribernik M, Ravnik D, et al. Anatomical variations in the pattern of the right hepatic veins: possibilities for type classification. J Anat, 2000, 197 Pt 3: 487-493.
22. 李虹璐, 喬英. 肝段下腔靜脈引流屬支的MSCT解剖及血管成像研究. 山西醫科大學, 2016.
23. 李杰, 李傳福. 肝右后下靜脈的超聲研究及臨床意義. 中國超聲醫學雜志, 1999, 15(11): 826-827.
24. 張彥, 李振平, 粱邦領, 等. 副肝靜脈的影像解剖學研究. 醫學影像學雜志, 2006, 16(2): 116-119.
25. Ng YY, Finn JP, Hall-Craggs MA. Inferior right hepatic veins: MR assessment of prevalence and potential clinical significance in children. Pediatr Radiol, 1990, 20(8): 605-607.
26. 徐慧婷, 徐凱, 何鵬, 等. 肝臟三維容積超快速多期動態增強磁共振成像在布加綜合征副肝靜脈檢出中的應用價值. 中華肝臟病雜志, 2016, 24(8): 585-589.
27. 姚斐斐, 程敬亮, 楊子濤, 等. 3.0 T 非對比劑肝門靜脈磁共振血管成像技術研究. 中國醫學影像學雜志, 2013, 21(11): 853-856.
28. 祖茂衡, 徐浩, 顧玉明, 等. 副肝靜脈在Budd-Chiari綜合征診斷與治療中的價值. 中華放射學雜志, 1998, 32(9): 616-619.
29. Fu YF, Wei N, Wu Q, et al. Use of accessory hepatic vein intervention in the treatment of Budd-Chiari syndrome. Cardiovasc Intervent Radiol, 2015, 38(6): 1508-1514.
30. 顧玉明, 祖茂衡, 徐浩, 等. 副肝靜脈成形術在Budd-Chiari綜合征治療中的應用. 中華放射學雜志, 2003, 37(1): 29-32.
31. 楊寧, 楊廣順. 原發性肝癌合并門靜脈高壓癥的診療現狀. 中華肝膽外科雜志, 2004, 10(10): 711-714.
32. Hwang S, Lee SG, Park KM, et al. Quilt venoplasty using recipient saphenous vein graft for reconstruction of multiple short hepatic veins in right liver grafts. Liver Transpl, 2005, 11(1): 104-107.
33. Makuuchi M, Hasegawa H, Yamazaki S, et al. Four new hepatectomy procedures for resection of the right hepatic vein and preservation of the inferior right hepatic vein. Surg Gynecol Obstet, 1987, 164(1): 68-72.
34. Xing X, Li H, Liu WG. Hepatic segmentectomy combined with major hepatic vein resection for preserving remnant liver lobe. Hepatobiliary Pancreat Dis Int, 2008, 7(2): 165-168.
35. Belghiti J, Guevara OA, Noun R, et al. Liver hanging maneuver: a safe approach to right hepatectomy without liver mobilization. J Am Coll Surg, 2001, 193(1): 109-111.
36. 彭淑牖, 曹利平, 李江濤, 等. 肝后隧道的建立與繞肝帶的使用在高難度肝切除術中的作用. 中華醫學雜志, 2003, 83(19): 1644-1647.
37. Kwak BJ, Kim DG, Han JH, et al. Clinical outcome of 1 000 consecutive cases of liver transplantation: a single center experience. Ann Surg Treat Res, 2018, 95(5): 267-277.
38. 韋力, 李啟強, 彭民浩, 等. 肝靜脈、肝短靜脈注入下腔靜脈壁處在肝移植術中的應用. 中國局解手術學雜志, 1999, 8(3): 177-179.
39. Ito K, Akamatsu N, Tani K, et al. Reconstruction of hepatic venous tributary in right liver living donor liver transplantation: The importance of the inferior right hepatic vein. Liver Transpl, 2016, 22(4): 410-419.

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Advances in clinical application of inferior right hepatic vein in hepatic surgery

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