Study On Arterial Distribution Of Extrahepatic Bile Duct By Microvascular Casting Technique

Pipe casting technology is a specialized in anatomical specimens of special production technology,for the research of viscera lumen or limb vascular construction,the pipe cavity injection filling agent,after being hardened to the rest of the organization corrosion or remove all bones,leaving only filler or retain bone filler facture method called cast specimen.The specimens produced are collectively referred to as pipeline cast specimens.Always more than the vascular study of extrahepatic bile duct through the way of gross anatomy after latex perfusion,focus on the source of the blood and vascular distribution within the hepatic hilar region?pancreas and duodenum,and the vascular connection and distribution characteristics between arterial chains of few people mention due to less detailed anatomic data,imaging characteristics also don't know,can't clear the position of these vessels and adjacent to,so that biliary surgery often appear biliary ischemic or hemorrhagic lesions.Objective:The purpose of this study was to find a suitable filling agent for extrahepatic bile duct arterial casting,elucidate the source of extrahepatic bile duct blood vessels and the characteristics of multiple annular vascular network between the arterial anastomosis chains of the superior and posterior duodenum of the common bile duct and provide detailed anatomical data for biliary surgery.Methods:(1)Perchloroethylene and resin materials were used in 2 cases.(2)Infusions of 6 sets of specimens were made according to the methods of non-pressure and local pressure,and the cast specimens were obtained by acidic corrosion.The blood supply of the cast specimens was observed and analyzed,and the characteristics of the cast specimens constructed by the two methods were compared.Results:(1)Acrylic resin was selected as the filling material.(2)The arterial cast specimens of 12(6 cases each)of the adult extrahepatic biliary tract clearly showed the main nutrient arteries of-the right hepatic artery of the extrahepatic biliary tract,the right hepatic artery,the left hepatic artery,the supraspinal and posterior portal arteries,the 3 o'clock arterial and the 9 o'clock arterial network of the hepatic portal area and the arterial ring of the lower common bile duct.(3)6 cases made of casting resin material partial pressure in addition to showing the extrahepatic bile duct outside the main nutrient artery,also in the hepatic duct on the duodenum of common bile duct segment and in the back of the part between observed at three o'clock and 9 o'clock artery also has a lot of lateral artery and hepatic duct above the hepatic arterial arch from the traffic around is a abundant longitudinal connection between the lateral artery 6 cases by mold recount arterial blood relationship between chain,found in the blood supply at the top of the main from the gallbladder of right hepatic artery and arch,the bottom mainly from pancreatic duodenal artery portal vein after gastroduodenal arteries and major branches,the supply of blood below about 53%,upper about 46%,the total hepatic artery in the middle about 1%.By measuring the diameter of the middle and both sides of each transverse artery,the transverse artery in the middle and upper part of the common hepatic duct was thicker,and the average diameter was(0.26±0.03)num and(0.23±0.06)mm,respectively.The ratio of the upper section is the largest,1.09,the middle section is second,1,and the average diameter of the middle section of the lower section is(0.14±0.03)mm.Diameter ratio was 0.74 in the middle on both sides of the inner most coarse.mainly because of the middle lateral sides near the right hepatic artery and gall bladder artery lateral to join.or directly by their branches on the transverse distribution of lateral artery coarser,the average diameter of(0.23±0.06)mm,with both sides of the inner diameter than the last paragraph,the largest is 1.1,compared with the minimum average diameter,(0.14±0.03)mm,the ratio is the smallest,is 0.74.Conclusions:(1)The local pressure method using acrylic resin as filler is applied to the cast perfusion of extrahepatic bile duct artery.(2)PhotoShop is a reliable method to measure the diameter of small vessels related to arterial anastomosis chain..(3)he proportion of-blood supply above and below the anastomosis artery chains on both sides of the extrahepatic bile duct was relatively balanced.(4)The blood supply of the hepatic main segment is abundant.The isolated site of orthotopic liver transplantation should be above the confluence of the gallbladder duct to retain the dense blood supply area of the upper part of the hepatic main segment,which is consistent with the current opinion.(5)In order to reduce the effect of trauma on the blood supply of extrahepatic bile duct,small longitudinal incision should be made as far as possible in the upper duodenum of the common bile duct and the lower part of the common liver duct.