肝断面对拢缝合技术在肝切除中的应用

The Management of Hepatic Remnant Facet During Hepatectomy

目的:探讨肝断面对拢缝合的技术要点及在肝外科的合理应用。方法:回顾性分析74例肝肿瘤患者肝切除手术中肝断面的处理方法。采用肝断面对拢闭合者68例,占91.9%,其中完全闭合者59例,肝断面敞开者6例。观察术后腹腔引流、术后出血、胆漏、腹腔感染、膈下积液、胸腔积液、切口感染等情况。结果:术后未发现大出血、胆漏、腹腔感染等严重并发症;膈下积液5例;需要处理的胸水9例;肝功能衰竭1例;切口感染2例。结论:肝断面对拢闭合是一种实用有效的肝外科技术,如果在手术中能够掌握技巧和灵活性的高度统一,可以明显降低术后并发症的发生率。

Objective: To explore the management of hepatic remnant facet and some skills during hepatic resection. Methods: The management of hepatic remnant facet in 74 liver neoplasm patients who underwent hepatic resection were analyzed retrospectively, the hepatic remnant facet stitch technique were used in 68 (91. 9%) patients. The hepatic remnant facet were entirely closed in 59 patients, while 6 patients got the remnant facet opened. We had measured the volume of drainage after the operation and observed the postoperative morbidity such as massive such as bleeding, bile leakage, subphenic infection, pleural infusion and wound infection. Results: We did not find severe complications such as bleeding and bile leakage. There were 5 patients occurred subphenic infection, 9 patients with pleural infusion that needed medical interference, 1 patient suffered liver dysfunction, and 2 got wound infection. Conclusion:The hepatic remnant facet stitch technique is a practical and safe method during hepatic resection, while just a reasonable use of it can decrease the morbidity of hepatecto-my.