肝脏膜结构再认识及在腹腔镜肝切除术中的应用

Re-understanding of liver membrane structure and its application in laparoscopic hepatectomy

摘要:

现代外科学的诞生源于对人体解剖学知识的不断积累，而外科学的飞速发展也促进了对脏器精细解剖的深入认识。肝脏作为人体最大的实质性脏器，其独特的双重血供、复杂的肝内脉管结构，使得手术过程中容易发生难以控制的出血。因此，长期以来肝脏手术都是普通外科难度较大的手术之一，需要较长的学习曲线。近30年来，随着腹腔镜肝切除术（LH）的迅速普及，外科医师发现利用以前未被充分重视的肝脏膜结构能够更便利、精准地解剖肝内、外脉管，定位切肝平面，减少术中出血。目前对肝脏膜结构在LH中应用的系统性阐述不多，笔者针对这一领域进行探讨。

Abstract:

The birth of modern surgery is attributed to the continuous accumulation of knowledge in human anatomy, and the rapid development of surgery also promotes in-depth understanding of fine organ anatomy. The liver as the largest solid organ in the human body has a unique dual blood supply system and complex intrahepatic vascular structures, make it prone to uncontrollable bleeding during surgery. Therefore, liver surgery has long been one of the most difficult operations in general surgery and requires a longer learning curve. In the past 30 years, with the rapid popularity of laparoscopic hepatectomy (LH), surgeons have discovered that the use of liver membrane structures, to which insufficient attention has been paid previously, can more conveniently and accurately dissect the internal and external vessels of the liver and locate the liver plane, and reduce intraoperative bleeding. At present, there are not many systematic explanations focusing on the application of liver membrane structure in LH. Therefore, the authors address the issues in this field.