腹部外科Hepaticdisease肝脏疾病2709619.pdfVIP

Hepatic disease ¨Anatomy ♦Tumor of liver • malignant tomor • benign tomor Tongji Medical College of HUST Gross anatomy ♦Lies in the upper quadrant of the abdomen ♦Largest gland in the body,weighs about 1500g(2% of the body weight) Adjacent to diaphragm, duodenum, colon, kidney,adrenal gland, esophagus, stomach, gallbladder Connect to the digestive tract by the portal vein and the biliary drainage system Ligaments of liver ♦ Falciform ligament ♦ Coronary ligament ♦ Left trianger ligament ♦ Right trianger ligament ♦ Round ligament Hepatic artery system • Portal vein and hepatic vein Lobe and segment of liver ♦ Portal fissure(left ♦ side of gallbladder fossa to the left side of inferior vena cava) ♦ Hepatic hila ♦ Couinaud system Blood flow ♦Blood supply hepatic artery 25%~30% portal vein 70%~75% ♦Oxygen supply hepatic artery 40%~60% portal vein 40%~60% Physiology ♦Metabolism carbohydrate, lipid, protein, bilirubin, vitamin ♦Metabolism of drugs and toxins ♦Bile secretion ♦Coagulation ♦Immune function ♦Other function Primary liver cancer ♦Primary liver cancer is the second most common malignent tumor in our country. ♦The patients are getting younger and younger. ♦The incidence of Qidong city of Jiangshu province is the highest in our country. ♦The mortality is 20.4/100000 ♦The incidence of South Africa is the highest in the world(103.8/100000). Etiology ♦ Liver cirrhosis of any cause probably plays an important role in development o