肝门区肝癌的手术治疗

Resection of the Hepatocarcinoma at Hilus Hepatis

８２例肝门区中晚期肝癌，肿瘤分布在肝脏的Ⅳ，Ｖ，Ⅷ和Ⅰ段，８７％的病人合并有肝硬变。采用常温下全肝血流阻断切肝术７例，阻断第一肝门切肝术７５例。手术经腹完成，不开胸，用框架式拉钩。术中一次性门脉化疗，或断面无水酒精注射。肝断面游离大网膜覆盖，膈下双套管引流。术后并发症少，手术死亡率低。术后１，３，５年总生存率分别为５２％，３７％和２２％。

Hepatic Liver cancer resection was done in 82 cases with cancerdistributing over Ⅳ,V,Ⅷ,Ⅰsegment of the liver. 87% of cases complicated cirrohosis of lvier.In 7 cases cancer resction was done with complere occulusion of the hepatice blood supply,in 75 cases,cancer resection was done with intermittent interruption of the portahepatis vessel under normal temperature. Our improvement on operative technique was abdominal incision without combind thoraco-abdominal incision,with frame contractor,large dosage chemotherapy in portal system before resction, absolute alcohol injection for raw resection surface of the liver,a piece of free omentum covering the raw surface of the liver,double cannel drinage tube installed in subphrenic region.Postoperative complications and operative mortality were less.The 1,,5 year postoperative survival rates were 52%,37%and 20%respectively.