Các ống dẫn và để lại bên trái cổng thông tin chi nhánh của tĩnh mạch được kết nối bởi các chi nhánh của động mạch gan trái, nhập vào khe rốn gan phân chia Trong thời hạn nào tàu đến và đi từ hợp lưu của ống dẫn thùy trái (phân đoạn II và III) và các thùy vuông (đoạn IV) có thể xảy ra. | 168 Heptobiliary Surgery Fig. . Relation of right and left hepatic ducts. Reprinted with permission from Surgery of the Liver and Biliary Tract 3rd Edition Blumgart LH Fong Y and WH Jarnigan Eds. . Saunders London UK 2000 . 13 The left duct and left branch of the portal vein are joined by the left branch of the hepatic artery enter the umbilical fissure of the liver within which division of vessels to and confluence of ducts from the left lobe Segments II and III and the quadrate lobe Segment IV occur. The left hepatic duct receives major tributaries from each of these segments which converge in the umbilical fissure dorsocranial to the left portal vein. Hepatic ductal tributaries from the quadrate lobe Segment IV and hepatic arterial and portal venous branches supplying it re-curve to Segments IVA and IVB Fig. . The ligamentum teres in the lower edge of the falciform ligament traverses the umbilical fissure of the liver which is usually but not always bridged in its lowermost part by a tongue of liver tissue joining the left lobe to the base of Segment IV. The ligament joins the umbilical portion of the left portal vein as it curves anteriorly and caudally giving off branches to Segments II and III of the left lobe and to Segment IV Fig. . The most common vascular anomaly is an accessory or replaced right hepatic artery originating from the superior mesenteric artery. This anomaly is present in about 20-25 of patients. The right hepatic artery runs posterolateral to the right of the common bile duct in close proximity to the cystic duct. The artery is prone to injury during cholecystectomy particularly if injury to the common bile duct occurs. Surgical Techniques for Completion of a Bilioenteric Bypass 169 Fig. . Extrahepatic course of the left hepatic duct within Glisson s capsule. Reprinted with permission from Surgery of the Liver and Biliary Tract 3rd Edition Blumgart LH Fong Y and WH Jarnigan Eds. . Saunders London UK 2000 . Its .
