中国普通外科杂志2026，Vol.35Issue(1)：77-87,11.DOI:10.7659/j.issn.1005-6947.250378
Laennec膜概念指导下肝门部肝段Glisson蒂的应用解剖及其腹腔镜手术应用价值
Applied anatomy of segmental Glissonian pedicles at the hepatic hilum guided by the Laennec's membrane concept and its value in laparoscopic surgery
摘要
Abstract
Background and Aims:Precise identification and control of segmental Glissonian pedicles are fundamental to laparoscopic anatomical liver segmentectomy.However,marked anatomical variations,particularly in the right hemiliver,pose significant technical challenges.Based on the anatomical concept of the hepatic Laennec's membrane,this study aimed to systematically investigate the applied anatomy of Glissonian pedicles at the hepatic hilum and to establish practical anatomical landmarks for laparoscopic anatomical liver resection. Methods:Six intact adult human liver specimens without macroscopic lesions were dissected under the guidance of the Laennec's membrane concept.The segmental Glissonian pedicles at the first porta hepatis were meticulously isolated,and the intervening liver parenchyma was removed.The origin,branching patterns,and spatial courses of Glissonian pedicles in each hepatic segment were analyzed.For the right hemiliver,a localization system consisting of four anatomical landmarks,two reference lines,and four characteristic angles was proposed and quantitatively evaluated using specimen measurements combined with CT imaging and three-dimensional liver reconstruction. Results:The intrahepatic Glissonian system demonstrated both consistent patterns and pronounced individual variations.In the left hemiliver,the Glissonian pedicles of segments Ⅱ and Ⅲ usually arose independently,while segment Ⅳ commonly presented a bifurcated pattern with occasional multiple branches.In contrast,the right hemiliver showed substantial variability:segment Ⅴ pedicles were frequently multibranched and often received contributions from segment Ⅵ;segment Ⅵ served as a pivotal pedicle with multiple branches contributing to segments Ⅴ and Ⅶ;segment Ⅶ most commonly originated from the root of the right posterior pedicle,although in some cases it was formed by distal extensions of segment Ⅵ;segment Ⅷ pedicles were relatively constant in morphology,typically consisting of one or two branches.The proposed anatomical landmarks and quantitative parameters enabled clearer spatial localization of segmental Glissonian pedicles in the right liver. Conclusion:Systematic dissection of segmental Glissonian pedicles guided by the Laennec's membrane concept,together with a quantitative anatomical landmark system,enhances the understanding of their spatial anatomy and variations.This approach provides practical and reliable anatomical guidance for precise and safe laparoscopic anatomical liver segmentectomy.关键词
肝/解剖标志/Glisson蒂/Leannec膜/腹腔镜Key words
Liver/Anatomic Landmarks/Glissonian Pedicle/Laennec's Membrane/Laparoscopes分类
医药卫生引用本文复制引用
常贵建,卓信斌,雷文俤,谢敏华,黄健,张勇,黄建敏,林德新..Laennec膜概念指导下肝门部肝段Glisson蒂的应用解剖及其腹腔镜手术应用价值[J].中国普通外科杂志,2026,35(1):77-87,11.基金项目
福建省自然科学基金资助项目(2021J011164). （2021J011164）
