肝脏良性肿瘤的分类与诊治原则

Hepatic resection combined with removal of the tumor emboli of the portal vein for the treatment of hepatocellular carcinoma.

肝脏良性肿瘤既往临床甚为少见,但由于近10多年来影像学检查手段的进步,临床发现的肝脏良性肿瘤亦日渐增多。鉴别肝脏良性与恶性肿瘤,亦已成为现代肝外科工作的重要内容之一。 1 肝脏良性肿瘤的分类根据组织学特点和临床实用方面考虑,兹将其分类如下。

Hepatectomy with removal of the tumor emboli of the portal vein (PV) were concomitantly performed in 25 cases with hepatocellular carcinoma. In these 25 cases, tumor was situated in left liver in 21, right liver in 4. Tumor size was 6--20cm (mean, 10.7cm). After resection of the left hepatic lobe, the tumor emboli were easily removed from the remnant of the left branch of PV. The 1/2--year, 1--year and 2--year survival rates were 95.4%, 47.0% and 20.0% respectively. While in the same period, 7 liver cancer patients with tumor emboli in the PV were hospitalized without operation, all died from esophageal varices bleeding or hepatic failure within 3 months. The merits of this combinative surgical treatment could be summarized as follows: (1) interruption of the tumor emboli continuously invade the PV; (2) decompression of the PV, reduces the morbidity of the esophageal varices rupture; (3) the sequential therapies could feasibly be proceeded.