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首页> 外文期刊>World Journal of Surgery: Official Journal of the Societe Internationale de Chirurgie, Collegium Internationale Chirurgiae Digestivae, and of the International Association of Endocrine Surgeons >Heterogeneity of subvesical ducts or the ducts of Luschka: a study using drip-infusion cholangiography-computed tomography in patients and cadaver specimens.
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Heterogeneity of subvesical ducts or the ducts of Luschka: a study using drip-infusion cholangiography-computed tomography in patients and cadaver specimens.

机译:膀胱下导管或Luschka导管的异质性:一项使用滴注胆管造影计算机断层摄影术对患者和尸体标本进行的研究。

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摘要

The objective of this study was to examine the heterogeneity of the subvesical duct or the ducts of Luschka as well as the reliability of drip-infusion cholangiography with computed tomography (DIC-CT) for their identification. DIC-CT was used in 277 consecutive patients (135 men, 142 women) and for the dissection and histologic study of 10 cadaver livers. We found 32 subvesical ducts in 28 (10.1%) of 277 patients. Irrespective of whether the terminals were extra- or intraparenchymal, the subvesical ducts often (17/32 ducts, 15/28 patients) drained into a subsegmental duct of S5 or S4. Notably, some displayed an "intermediate" course along the gallbladder fossa with an intraparenchymal origin and terminated at S5. Such ducts tended to be seen in the elderly. Another 15 ducts drained into a thick, centrally located duct, such as the right sectorial or hepatic duct. The anatomic study demonstrated that the subvesical duct likely included the cystic vein-concomitant duct. A major type of subvesical duct, characterized by an intermediate course along its bed, appeared to result from degenerative exposure of a peripheral duct with aging. The subvesical duct draining into the thick duct included both a "daughter branch," such as seen in the lung, and the so-called anomaly. Such ducts can be demonstrated with DIC-CT, but the incidence might be limited. However, the cystic vein/concomitant duct was difficult to identify radiologically. Consequently, although presurgical radiology is useful for avoiding bile leakage after laparoscopic cholecystectomy, surgeons should be aware of its limitations.
机译:这项研究的目的是检查膀胱镜或Luschka导管的异质性,以及通过计算机断层扫描(DIC-CT)进行识别的滴注胆道造影的可靠性。 DIC-CT用于277例连续患者(135例男性,142例女性),并用于10具尸体肝脏的解剖和组织学研究。我们在277例患者中的28例(10.1%)中发现了32条膀胱下导管。不论末端是实质外还是实质内,经常将膀胱下导管(17/32导管,15/28例患者)引流到S5或S4的节段导管中。值得注意的是,有些患者沿胆囊窝呈“中间”病程,起源于实质内,并在S5终止。这样的导管往往在老年人中可见。另外15条导管排入厚的中央导管,例如右扇形或肝导管。解剖学研究表明,膀胱下导管可能包括囊性静脉伴随导管。一种主要的膀胱下导管,其特征是沿着其床的中间路线,似乎是由于老化引起的外周导管的退化暴露所致。进入厚导管的膀胱下导管包括“子支”(如在肺部可见)和所谓的异常。可以用DIC-CT证实这种导管,但发生率可能有限。然而,胆囊静脉/伴随导管很难通过放射学鉴别。因此,尽管术前放射学可避免腹腔镜胆囊切除术后胆漏,但外科医生应意识到其局限性。

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