手术治疗肝癌破裂出血32例

Hepatic resection for bleeding of ruptured hepatocellular carcinoma in 32 cases

目的总结肝切除术治疗肝癌破裂出血的选择及疗效。方法回顾性分析32例肝癌破裂出血肝切除术的肿瘤分布、手术方式及手术疗效。结果急诊肝癌切除26例，肝动脉结扎术后二期切除6例；左肝癌切除11例，右肝癌切除21例。术后均无再出血，2例术后死于肝功能衰竭，13例术后生存6～12月，17例术后生存12月以上。结论肝切除术既能达到止血目的，又能切除病灶，是治疗肝癌破裂出血的首选方法。

Objective To evaluate the effect of hepatic resection for bleeding of ruptured hepatocellular carcinoma. Methods The tumor distribution, patterns of operation and therapeutic effect of 32 patients with ruptured hepatocellular carcinoma undergoing hepatic resection was retrospectively analyzed. Results 26 patients underwent emergency hepatic resection and 6 patients underwent delayed hepatectomy. 11 cases underwent left hepatic resection and 21 cases underwent right hepatic resection. There was no rebleeding after operation and two cases died of liver failure,13 cases survived for 6-12 months after operation,and 17 cases survived for more than 12 months. Conclusion Surgical resection is the first choice for the management of bleeding of ruptured hepatocellular carcinoma, which can prevent bleeding and resect the lesion.