Anastomosen zwischen Segmentarterien der Leber und phrenico-hepatische arterio-arterielle Anastomosen

Reimann, Brigitte; Lierse, W.; Schreiber, Hans

doi:10.1007/bf01257255

Cited by 20 publications

(13 citation statements)

References 16 publications

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“…They can be located in the hepatic hilum, in the subcapsular plexus, and in the translobar vessels. It is an interesting point that most of these vessels have been located in the DSL [27]. The number of these vessels per specimen is not noted in literature data, and we think that the finding of four vessels per specimen is highly unusual.…”

Section: Discussionmentioning

confidence: 87%

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Arterial Ring Encircling the Bile Duct with Coexisting Anomalous Liver Irrigation

Dušanović

Ignjatović²,

Knežević³

et al. 1999

Dig Surg

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Analysis of the arterial system of the liver in a 64-year-old male cadaver revealed an anomaly of the branching of the proper hepatic artery. The right branch of the hepatic artery was missing, replaced by two segmental arteries, so that a ‘trifurcation’ occurred, consisting of two segmental arteries, anterior segmental and posterior segmental, and the left branch of the hepatic artery. These segmental arteries formed an arterial ring around the common hepatic duct, completely encircling it. A single cystic artery unusually originated from the posterior segmental artery. An extremely rare anatomical variation of the dorsal liver segment irrigation proves the fact that anatomical anomalies are usually multiple. The arterial blood supply for the dorsal liver segment is through four separate vessels (‘quadruple type’), two originating from the left branch of the hepatic artery and two from the posterior segmental artery. These four arteries presented numerous anastomotic bridges among themselves.

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Section: Discussionmentioning

confidence: 87%

“…The anastomotic bridges between the system of the right and left branches of the AHP are not frequent [25, 26, 27]. However, it is well noted that if abnormal anatomical relations exist, these anastomotic blood vessels become more frequent [4, 28].…”

Section: Discussionmentioning

confidence: 99%

Arterial Ring Encircling the Bile Duct with Coexisting Anomalous Liver Irrigation

Dušanović

Ignjatović²,

Knežević³

et al. 1999

Dig Surg

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“…Eine Oberfl/ichenkfihlung hat gegenfiber der warmen Ischfimie keine wesentlichen Vorteile; zum einen werden die zentralen Bereiche der Leber aufgrund der Gr6ge des Organs nicht erreicht, zum anderen kommt es durch die zusfitzliche Versorgung z. B. der kranialen Anteile der Leber durch Zwerchfellarterien zu einer regional sehr unterschiedlichen Abkfihlung [29]. Die hypothermie In-situ-Perfusionskiihlung der Leber wurde von Fortner experimentell und in der klinischen Anwendung beschrieben [6,7].…”

Section: Abstract: Liver Resection -Pringle Manoevre -Ischemic Time unclassified

“…Der ICG-Test gilt in der Dosierung von 0,5 mg/kg KG als ein Parameter ffir die Leberdurchblutung. Es ist bekannt, dab das Operationstrauma und die Auswirkungen der Narkose zu einer Reduktion der Leberdurchblutung ffihren [29,31]. Eine Normalisierung wird in der Regel nach 3-6 Tagen beobachtet [12].…”

Section: Diskussionunclassified

In-situ-Protektion der Leber mit der HTK-L�sung nach Bretschneider

Lamesch

Raygrotzki

Kehrer

et al. 1991

Langenbecks Arch Chiv

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Liver resections are usually performed under occlusion of the hepatoduodenal ligament (Pringle manoeuvre) in order to limit operative blood loss. The maximal ischemic tolerance, although individually different, is generally accepted to be 60 min. Resections of centrally located tumors require precise preparation, sometimes combined with vascular reconstructions. In such cases a prolonged ischemic time is inevitable. A save prolongation of the ischemic tolerance could be useful for extensive liver resections. In an experimental study in pigs ischemic tolerance of the liver was studied under hypothermic protection with the HTK solution of Bretschneider during 2 and 3 h. Deterioration of liver function was compared with a warm ischemia during 2 h. Results showed significantly less serum transaminase activities and better hepatic blood flow (ICG test) after an ischemia under protection with the HTK solution compared to a warm ischemia during 2 h. A prolonged ischemia during 3 h under protection with the HTK solution was well tolerated. First clinical applications of hypothermic hepatic protection during resection were successful.

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“…Aberrant left hepatic arteries may supply only one segment or the entire left hepatic lobe [6]. Collateralization exists between the intrahepatic arteries and the phrenic arteries, so that if ligation occurs it will not lead to necrosis of the liver lobe in most instances [14]. However, there is evidence in the literature of lethal necrosis of the left liver lobe after ligation of an ALHA [5,11].…”

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confidence: 99%