Petkov, P.

English

Varna Medical University Press: Journals

ANATOMO-TOPOGRAPHIC INVESTIGATIONS ON THE ANTERIOR HEPATIC NERVE PLEXUSP. PetkovIn recent years considerable attention has been focused on the anatomy of the anterior hepatic nerve plexus (AHNP) since the latter has become the site of operation in treatment of chronic interstitial hepatitis.Ariancff (5) identifies ihree distinct parts of the AHNP: one plexiform with length of the nerve fibers reaching up to 1 cm, a second one — chord- like with length of the fibers ranging from 1—2 cm and a third one — juxta- arterial, with length of the fibers up to several centimeters.The investigations on the AHNP structure, carried out by the author with standard dissection techniques, lended support up to a certain extent to the findings reported by Arianoff. The dissection method appeared to be the most adequate in studying the juxta-arterial portion of the plexus. The nerve trunks of the juxta-arterial part displayed orientation towards the extrahepatic tract cf the biliary system, pancreas and the other nearby situated organs. The nerve supplying the Oddi’s sphincter innervation, de­scribed by Reich (6), was Irated up in the juxtaarterial part. According to Sthafircff (7), it is feund in 80% cf the cases. It was furthermore established, that most frequently, the nerve originates frem two pedicles along the anterior wall cf the ccmmcn hepatic artery (Fig. 1). The nerve thus created gradually goes away and beneath the artery, running a course to the right- side c f the pancreas, between the gastroduodenal and right gastric artery (Fig. 2 — on the picture the nerve is black paper mounted for better contrast) and approximates the biliary tract just behind its pancreatic portion. In 23 or 92% of a total of 25 human cadavers investigated, the nerve just re­ferred to was found well formed and overlying the anterior aspect of the common hepatic artery. Merely in two specimens the nerve was not develo­ped and was represented by numerous, delicate, long fibers which failed to form a common (unique) nerve trunk.Aiming the quantitative determination of nerve elements within the cord-like and plexiform portion of the anterior hepatic nerve plexus, a histochemical method was resorted to with staining total preparations of the same. Thus a more clearcut distinction of the nerve fibers from blood and lymphatic vessels and connective tissue was provided for. A similar procedure was not found in the literature references surveyed. The total preparations of the common hepatic artery together with the nerve plexus elements and the surrounding fatty tissue were obtained from fresh human cadavers. The preparations were abundantly washed up with water for 2—3 hours and cleansed with pincers and scalpel, the major part of fatty tissue being removed. The method described by M. T. Shubich and A. B. Hodos, slightly modified, was employed fer the staining of the nerve plexus and clearing of the preparations. Initially, the preparations were left for96 P. Petkov 23 Anatomo-Topographic Investigations. . . 972—3 hours in 5% sulfosalicylic acid, and thereafter they were stained by immersion into Schiff’s reagent for 24 hours. Next, they were consecutively placed into a jar containing sulfurated water and kept for 30 min, and in two more basins containing sulfurated water — for further 24 hours. The preparations were cleared in a mixture: one part glycerin and two parts sulfurated water for 24 hours, and in pure glycerin — for further 72 hours. Merely the nerve fibers remained purple tinged. Ten specimens in all were prepared in this manner and examination was performed with biocular lense. Nerve elements were not detected in stained plexiform part. The lat­ter finding warrants the assumption that adventitial connective tissue elements predominate in its structure. The greatest number of stained nerve elements was established in the cord-like portion; they were situated longi­tudinally, in the same direction as the artery and running the same course. They penetrate the hepatic parenchyma together with the artery.R E F E R E N C E S1. В о р о б ь о в ,  В. A., P. Д.  С и н е л ь н и к о в .  Атлас анатомии человека, V,344-348, М „ 1948.2. Ч и с л о в с к и ,  К. И. Вран. дело, I, 1963.3. Е ф и м и ш и н ,  А. С. Хирургия, 1964, 3.4. Ш у б и ч ,  М. Т., А.  Б. Х о д о с .  Арх. анат., гист., змбр., 1964, 7.5. A r i a n o f f ,  A. A. Acta chir. Belgica, 1963, 1.S. H a f f e r ,  H. Journal de chirurgie, 84, 1962, 5.7. R o u x ,  M. Pathologie chirurgicale des voies billiaires extrahepatiques, Paris, 1961ТОПОГРАФИЧЕСКО-АНАТОМИЧЕСКИЕ ИЗУЧЕНИЯ П Е РЕД HE ГО ПЕЧЕНОЧНОГО-НЕРВНОГО СПЛЕТЕНИЯГ1. Петков Р Е З Ю М ЕАвтор изготовляет тотальнме, просветлени не препарати из общей печеночной артерии, вместе с хордоподобной и плексиформенной частями переднего печеночного нервното сплетения и окрашивает гистохимически нервнне волокна. Он находит, что в структуре плексиформенной части преобладают адвентициальнне соединительнотканевме злементн, в то время как в хордоподобной — преобладают нервнне волокна, которне следуют ход артерии и проникают в паренхиму печени.7 Srlpta «clentitlca medlca, vol. III. fase. !

ANATOMO-TOPOGRAPHIC INVESTIGATIONS ON THE ANTERIOR HEPATIC NERVE PLEXUS

https://journals.mu-varna.bg/index.php/ssm/article/download/4954/4226

ANATOMO-TOPOGRAPHIC INVESTIGATIONS ON THE ANTERIOR HEPATIC NERVE PLEXUS

Abstract

Similar works

Full text

Available Versions

Varna Medical University Press: Journals