キタジマ クミコ   KITAJIMA Kumiko
  北島 久視子
   所属   医学部 医学科(東京女子医科大学病院)
   職種   助教
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Fusion of the planes of the liver: an anatomic entity merging the midplane and the left intersectional plane.
掲載誌名 正式名:Journal of the American College of Surgeons
略  称:J Am Coll Surg
ISSNコード:10727515/10727515
掲載区分国外
巻・号・頁 200(5),pp.711-9
国際共著 国際共著
著者・共著者 Savier Eric, Taboury Jacques, Lucidarme Olivier, Kitajima Kumiko, Cadi Mehdi, Vaillant Jean-Christophe, Hannoun Laurent
発行年月 2005/05
概要 BACKGROUND:Alignment of the gallbladder fossa and the round ligament may be associated with an almost unknown portal vein branching anomaly.STUDY DESIGN:Ultrasonographic imaging allowed detection of this anomaly, which we characterized as fusion of the planes of the liver. When appropriate, additional specific radiologic examinations were performed (CT scanner supplemented with a three-dimensional reconstruction, a biliary cartography, or an angiography). Surgical consequences were studied from this series and from the literature.RESULTS:Seven patients (0.5%) had the following criteria: 1) round ligament, gallbladder fossa, and termination of the portal vein occurring in the same plane; 2) typical portal vein branching, including a right posterior branch, left branches, and a main medial branch terminated by the Rex's recessus; 3) two main hepatic veins without a significant middle hepatic vein; and 4) absence of the horizontal part of the left hepatic duct. Fusion of the planes may have been involved in two cases of iatrogenic bile duct injury and contraindicated a tumor resection and a right-liver donation. A review of the literature revealed that lack of recognition of the fusion of the planes led to a high proportion of surgical iatrogenic injury. Fusion of the planes could result from incomplete development of the central part of the liver, in agreement with embryologic knowledge.CONCLUSIONS:Knowledge of the fusion of the planes by hepato-biliary surgeons is important. This anomaly may lead to serious complications if it remains undetected during liver resection or bile duct surgery.
DOI 10.1016/j.jamcollsurg.2004.12.017
PMID 15848361