与卡洛三角有关的囊性动脉起源及走行变异的研究

A. Pradhan, C. Lama, S. Dhungel
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摘要

卡洛三角是一个解剖空间,又称“胆囊切除三角”。中间以肝总管为界,外侧以肝囊管为界,上部以肝下表面为界,其主要包含囊动脉。囊性动脉的起源和路线的变化会导致严重的问题,导致在任何外科手术中严重的动脉出血。因此,卡洛三角的变化对外科医生来说是非常重要的。在尼泊尔加德满都的两所医学院解剖学系进行了一项观察性横断面研究。共解剖30具尸体,27例(90.0%)囊性动脉起源于右肝动脉,平均长度为11.47 mm。囊性动脉来自肝固有动脉1条(3.3%),来自肠系膜上动脉1条(3.3%),来自肝副动脉1条(3.3%),囊性动脉长度分别为15.88 mm、27.49 mm和24.17 mm。囊性动脉位于卡洛三角区内外,分别占96.7%和3.3%。26例(86.7%)囊性动脉经肝总管后方。2例(6.7%)囊性动脉位于肝总管前部。1例(3.3%)位于胆管前方,1例(3.3%)位于左右肝管之间。总之,胆囊动脉的起源和路线的变化在胆囊切除术(开放或腹腔镜)中是必不可少的。
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Study of variations in origin and course of cystic artery in relation to Calot’s triangle
Calot’s triangle is an anatomical space and also known as “triangle of cholecystectomy”. It is bounded medially by Common hepatic duct, laterally by cystic duct, and superiorly by the under surface of liver and its main contain is Cystic artery. The variation in the origin and course of the cystic artery can cause serious problems resulting, severe arterial bleeding during any surgical procedures. Hence, variations in the Calot’s triangle are very important for the surgeons. An observational cross sectional study was carried out in Department of Anatomy of two Medical Colleges in Kathmandu, Nepal. A total of 30 embalmed human cadavers were dissected, in 27 cases (90.0%), cystic artery arose from right hepatic arteries, the mean length was 11.47 mm. One (3.3%) cystic artery arose from proper hepatic artery, one (3.3%) from superior mesenteric artery and one (3.3%) from accessory hepatic artery and the length of the cystic arteries were found to be measured as 15.88 mm, 27.49 mm and 24.17 mm respectively. The cystic artery was also found to be lying inside and outside the Calot‘s triangle in 96.7% and 3.3% respectively. In 26 cases (86.7%) cystic arteries were observed as passing posterior to the common hepatic duct. Further in 2 cases (6.7%) cystic arteries were found to be lying anterior to the common hepatic duct. Result also showed as in 1 case (3.3%) it was running anterior to the bile duct and in 1 case (3.3%) between right and left hepatic ducts. In conclusion the variations in the origin and course of the cystic artery are essential in performing cholecystectomy (open or laparoscopic).
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