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中华普通外科学文献(电子版) ›› 2026, Vol. 20 ›› Issue (02) : 73 -78. doi: 10.3877/cma.j.issn.1674-0793.2026.02.001

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肝圆韧带在肝胆胰外科修复重建中的应用
刘志伟, 朱文涛, 陈强谱()   
  1. 256600 滨州,滨州医学院附属医院胆胰外科
  • 收稿日期:2025-08-16 出版日期:2026-04-01
  • 通信作者: 陈强谱
  • 基金资助:
    山东省科学技术发展计划项目(2009GG10002047); 山东省省级临床重点专科学科建设基金资助项目(SLCZDZK-0701); 山东省省级临床重点专科胆胰肿瘤精品特色专科建设基金资助项目(SLCZDZK-2401)

Application of the ligamentum teres hepatis in hepatopancreatobiliary surgery repair and reconstruction

Zhiwei Liu, Wentao Zhu, Qiangpu Chen()   

  1. Department of Hepatobiliary and Pancreatic Surgery, Binzhou Medical University Hospital, Binzhou 256600, China
  • Received:2025-08-16 Published:2026-04-01
  • Corresponding author: Qiangpu Chen
引用本文:

刘志伟, 朱文涛, 陈强谱. 肝圆韧带在肝胆胰外科修复重建中的应用[J/OL]. 中华普通外科学文献(电子版), 2026, 20(02): 73-78.

Zhiwei Liu, Wentao Zhu, Qiangpu Chen. Application of the ligamentum teres hepatis in hepatopancreatobiliary surgery repair and reconstruction[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2026, 20(02): 73-78.

肝圆韧带(LTH)是左脐静脉闭锁形成的存在潜在腔隙组织,具备取材便捷、生物相容性好及无免疫排斥反应等优势,近年来在肝胆胰外科修复重建领域的应用价值日益受到关注。LTH的临床应用涵盖了手术创面止血、胆管缺损修复、胆肠及胰肠吻合口加固以预防胆漏或胰漏、腹部血管修复重建等诸多领域。本文介绍了LTH的解剖及组织学特性,并对其在肝脏、胆道、胰腺以及腹部血管手术中的应用进行了讨论,展望其应用前景。

The ligamentum teres hepatis (LTH), a fibrous band with a potential lumen formed from the obliterated left umbilical vein, offers distinct advantages, including accessibility, good biocompatibility, and absence of immunogenic rejection. In recent years, its value in reconstructive surgery within hepatobiliary and pancreatic surgery has garnered increasing attention. The clinical applications of LTH encompass a wide spectrum, such as achieving surgical hemostasis, repairing biliary defects, reinforcing bilioenteric or pancreaticojejunal anastomoses to prevent bile or pancreatic fistula, and facilitating abdominal vascular reconstruction. This paper describes the anatomical and histological characteristics of LTH and discusses its applications in liver, biliary tract, pancreatic, and abdominal vascular surgery, while also exploring its prospects.

图1 肝圆韧带修剪及扩张 A. 扩张再通后的肝圆韧带;B. 扩张再通后肝圆韧带内壁;C. 修剪后备用的肝圆韧带
图2 肝圆韧带修复重建血管手术示意图 A. 肝圆韧带补片修补门静脉/肠系膜上静脉侧壁;B.肝圆韧带节段替代门静脉;C. 肝圆韧带节段替代肠系膜上静脉;D. 肝圆韧带节段替代门静脉-肠系膜上静脉结合部
图3 肝圆韧带修复重建血管术中图片 A. 肝圆韧带补片修补门静脉侧壁;B. 肝圆韧带节段替代门静脉;C. 肝圆韧带节段替代肠系膜上静脉;D. 肝圆韧带节段替代门静脉-肠系膜上静脉结合部;LTH:肝圆韧带;PV:门静脉;SMV:肠系膜上静脉;SV:脾静脉
图4 肝圆韧带节段替代门静脉-肠系膜上静脉术后影像学图像
图5 利用肝圆韧带行分流术 A. 肠系膜上静脉-下腔静脉“H”形分流;B. 门静脉-下腔静脉H形分流;SMV:肠系膜上静脉;IVC:下腔静脉;PV:门静脉
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