Summary
The aim of this study was to establish a plan of the arterial distribution to the main supraduodenal biliary tract in order to draw practical conclusions for biliary surgery, especially in bilio-alimentary and biliobiliary anastomoses and liver transplantation. It was based on a study of 60 fresh subjects and was carried out using four different methods: dissection after injection of colored latex into the superior mesenteric a. (10 subjects), radiography and dissection after injection of Micropaque into the celiac trunk (10), dissection after injection of Indian ink into the common hepatic a. (10) and radiography and dissection after selective injection of the right hepatic a. or the gastroduodenal a. (30). Analysis of the results leads to definition of three types of vascularisation and two territories, superior and inferior, overlapping at the level of the mouth of the cystic duct. The practical implications for biliary surgery and liver transplantation are discussed.
Résumé
Ce travail a pour but d'établir une schématisation de la distribution artérielle de la voie biliaire principale supra-duodénale, afin d'en tirer des conséquences pratiques en chirurgie biliaire, notamment lors des anastomoses bilio-digestives, biliobiliaires et des transplantations hépatiques. Il repose sur l'étude de soixante sujets frais et a été effectué selon quatre protocoles différents : dissection après injection de latex coloré, dans l'artère mésentérique supérieure (10 sujets) radiographies et dissections après injection de micropaque dans le tronc coeliaque (10) dissections après injection d'encre de chine dans l'artère hépatique commune (10), radiographies et dissections après injections sélective dans l'artère hépatique droite ou l'artère gastroduodénale (30). L'analyse des résultats permet de définir trois types de vascularisation et deux territoires, supérieur et inférieur, se chevauchant au niveau de l'abouchement du canal cystique. Les applications pratiques en chirurgie biliaire et lors des transplantations hépatiques sont discutées.
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This study was made with the aid of a grant from the Fondation Martine Midy.
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Rath, A., Zhang, J., Bourdelat, D. et al. Arterial vascularisation of the extrahepatic biliary tract. Surg Radiol Anat 15, 105–111 (1993). https://doi.org/10.1007/BF01628308
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DOI: https://doi.org/10.1007/BF01628308