Morphological Transformations of Tubular Structures of the Fetuses Hepatoduodenal Ligament

Abstract

The components of the hepatoduodenal ligament play an important role in the process of digestion. Calculi in the common bile duct are found in 10-15% of individuals suffering from chronic calculous cholecystitis, and obstruction of bile ducts is found in 59,1-67,4% of cases. The objective of the study was to investigate peculiarities of component morphogenesis of the hepatoduodenal ligament during the perinatal period of human ontogenesis, individual and age anatomical variability, spatial-temporal transformations, and anatomical-histological peculiarities of its structures. To achieve the stated purposes the following complex of methods was used: macroscopic – for visual detection of the state of the hepatoduodenal ligament components, vascular injection – to study peculiarities and variants of angioarchitectonics of the arterial components of the hepatoduodenal ligament, statistical – to determine peculiarities of morphological transformations of the components and adjacent structures of the hepatoduodenal ligament at different periods of prenatal and postnatal periods of human ontogenesis. According to the results of the study several accessory triangles of the hepatoduodenal ligament were found and described. The common bile duct, the common hepatic duct, cystic duct, left and right hepatic ducts, hepatic portal vein, common hepatic artery, right gastric artery, hepatic artery proper, right, left and accessory branches of the hepatic artery proper are permanent components of the ligament forming a number of combinations-crossings between themselves. Meanwhile, we have determined certain regularities of the formed pattern including minimum 5 permanent triangles to be distinguished: Calot’s triangle or "superior lateral triangle", "superior medial triangle", "inferior medial triangle", "inferior lateral triangle", "central space of the hepatoduodenal ligament".