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Glissonean pedicle approach in liver surgery

机译:Glissonean椎弓根入路在肝脏外科手术中的应用

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摘要

Glisson's capsule was discovered by Johannis Walaeus in 1640 and described by Francis Glisson in 1654. The capsule wraps the hepatic artery, the portal vein and the bile duct in the liver and forms bundles at the hepatic hilus and in the liver as the Glissonean pedicle tree. Glisson's capsule does not connect to the proper membrane of the liver, which was discovered by Laennec; therefore, the Glissonean pedicles can be detached from the liver parenchyma without liver dissection. Couinaud described three main approaches to control the inflow system at the hepatic hilus in liver surgery; the intrafascial approach, the extrafascial and transfissural approach, and the extrafascial approach. The intrafascial approach is the so‐called control method. The extrafascial and transfissural approach, and the extrafascial approach are recognized as the Glissonean pedicle approach. When the Glissonean pedicles are ligated before liver transection, various types of anatomical hepatectomy can be carried out. The Glissonean pedicle approach is, therefore, considered to be one of the most important procedures in liver surgery. We herein describe the historical aspects and procedures of the Glissonean pedicle approach in liver surgery.
机译:Glisson的胶囊由Johannis Walaeus于1640年发现,并于1654年由Francis Glisson进行了描述。该胶囊包裹肝动脉,门静脉和胆管在肝脏中,并在肝和肝中成束,形成Glissonean蒂树。 。莱森(Laennec)发现,格里森(Glisson)的胶囊未与肝脏的适当膜连接;因此,格里森氏蒂可以从肝实质中分离出来,而无需进行肝脏解剖。 Couinaud描述了在肝外科手术中控制肝门处流入系统的三种主要方法。筋膜内入路,筋膜外和经筋膜入路以及筋膜外入路。筋膜内方法是所谓的控制方法。筋膜外和经裂口入路,以及筋膜外入路被认为是格里森氏椎弓根入路。当在肝横切之前结扎格里森氏椎弓根时,可以进行各种解剖型肝切除术。因此,Glissonean椎弓根入路被认为是肝脏外科手术中最重要的手术之一。我们在本文中描述了在肝脏外科手术中Glissonean椎弓根入路的历史方面和程序。

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