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Along with the development of liver transplant techniques, clinical efficacy of liver transplantation has been significantly improved, and the survival of the recipients and liver grafts has been remarkably prolonged. However, the source of organ donation after citizen' s death still fails to meet the requirement of liver transplantation. The shortage of donor liver limits further development of liver transplantation. In recent years, living donor liver transplantation has been widely used in the treatment of patients with end-stage liver disease as one of the means to resolve organ shortage. As a special type of living donor liver transplantation, right posterior segmental graft liver transplantation provides a novel solution for expanding the potential donor pool for living donor liver transplantation. In this article, the development profile of living donor liver transplantation, donor selection of right posterior segmental graft for living donor liver transplantation, anatomical challenges of right posterior segmental graft procurement and surgical skills of right posterior segmental graft procurement were reviewed. Moreover, the prospect of right posterior segmental graft for living donor liver transplantation was predicted, aiming to promote the development of liver transplantation in clinical practice and bring benefits to more patients with end-stage liver diseases.
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Objective To study the pattern of cystic duct (CD) drainage into hepatic ducts (CDIHD) by using three dimensional magnetic resonance cholangiopancreatography (3D M RCP) combined with conventional MRI sequences.Methods Thirty-eight patients with CDIHD were studied retrospectively and they served as the observation group.Another 38 patients who had no CDIHD were selected randomly and they served as the control group.The hepatic bile duct where the CD drained in the observation group,the site where the common hepatic duct (CCHD) started,and the types of the intrahepatic bile duct (IHBD) in the two groups were analyzed.The types of the IHBD were classified according to the modified Couinaud's criteria.Results There were 26 patients who had their CD draining into the right liver bile ducts,9 into the incomplete common hepatic duct,and 3 into the left hepatic duct in the observation group.For the types of IHBD in the observation/control groups,type A was observed in 15/19 patients,type B in 0/6,type C in 22/1,type D in 0/9,type E in 0/2,and type F in 1/1,respectively.The differences were significant (P ＜ 0.05).The number of patients who had their CCHD starting in the porta hepatis,superior duodenal bulb,posterior duodenal bulb,and pancreatic head in the observation/control groups,were 1/36,19/2,17/0,1/0,respectively.The differences were also significant (P ＜ 0.05).Conclusion In patients with CDIHD,CD most commonly drained into the right hepatic duct.Patients with CDIHD had a different IHBD type,and the IHBD confluence was lower.
RESUMO
Objective To study the pattern of cystic duct (CD) drainage into hepatic ducts (CDIHD) by using three dimensional magnetic resonance cholangiopancreatography (3D M RCP) combined with conventional MRI sequences.Methods Thirty-eight patients with CDIHD were studied retrospectively and they served as the observation group.Another 38 patients who had no CDIHD were selected randomly and they served as the control group.The hepatic bile duct where the CD drained in the observation group,the site where the common hepatic duct (CCHD) started,and the types of the intrahepatic bile duct (IHBD) in the two groups were analyzed.The types of the IHBD were classified according to the modified Couinaud's criteria.Results There were 26 patients who had their CD draining into the right liver bile ducts,9 into the incomplete common hepatic duct,and 3 into the left hepatic duct in the observation group.For the types of IHBD in the observation/control groups,type A was observed in 15/19 patients,type B in 0/6,type C in 22/1,type D in 0/9,type E in 0/2,and type F in 1/1,respectively.The differences were significant (P ＜ 0.05).The number of patients who had their CCHD starting in the porta hepatis,superior duodenal bulb,posterior duodenal bulb,and pancreatic head in the observation/control groups,were 1/36,19/2,17/0,1/0,respectively.The differences were also significant (P ＜ 0.05).Conclusion In patients with CDIHD,CD most commonly drained into the right hepatic duct.Patients with CDIHD had a different IHBD type,and the IHBD confluence was lower.
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Objective To explore the main anatomical factors for relapse in patients underwent radical mas-toidectomy and discuss the preventive measures .Methods A retrospective study was carried out 36 patients who had underwent radical mastoidectomy and 100 patients (100 ears) who had been cured underwent radical mastoidectomy during July 2011 toSeptember 2013 .The patients underwent axial and coronal temporal Computed Tomography (CT) .The incidence of low -lying middle cranial fossa ,high jugular bulb ,anterior locati(36 ears)on of sigmoid si-nus ,dehiscent tympani tegmen ,dehiscent of the facial nerve canal ,large sinus tympani ,low -lying horizontal facial nerve were recorded .Results The incidence of low -lying middle cranial fossa(36 .1% ) ,anterior location of sig-moid sinus(41 .7% ) ,dehiscent tegmen tympani (30 .6% ) ,dehiscent of the facial nerve canal (41 .7% ) ,large sinus tympani(25 .0% ) ,low -lying horizontal facial nerve(22 .2% ) were higher than those of in the normal group .There was no significant difference in high jugular bulb .Conclusion The main anatomical factors for relapse in patients un-derwent radical mastoidectomy were low -lying middle cranial fossa ,anterior location of sigmoid sinus ,dehiscent tegmen tympani ,dehiscent of the facial nerve canal ,large sinus tympani ,low -lying horizontal facial nerve .