肝后下腔静脉隧道绕肝带提拉法半肝切除19例报告

Hemihepatectomy by retrohepatic tunnel of the IVC of liver hanging maneuver:a report of 19cases

目的探讨肝后下腔静脉隧道绕肝带提拉法行半肝切除安全性的作用。方法回顾性分析2003年11月至2006年6月昆明医学院第一附属医院肝胆外科,在传统经典半肝切除术的基础上加用肝后下腔静脉隧道绕肝提拉法行半肝切除的19例资料。结果19例均成功放置绕肝带,未发生与该操作有关的并发症,半肝切除时肝正中裂界面内管道显露清楚,处理起来方便、安全可靠,绕肝带具有指示保护肝后下腔静脉的作用。结论半肝切除时采用肝后下腔静脉隧道绕肝带提拉法,可进一步提高半肝切除的安全性,减少出血,缩短手术时间。保证断肝能在最薄、最小的界面进行。

Objective To enhance the operation safety of hemihepatectomy with improvements by retrohepatic tunnel of the IVC of liver hanging maneuver. Methods The clinical data of 19 cases of Hemihepatectomy by retrohepatic tunnel of the IVC of liver hanging maneuver performed between November 2003 and June 2006 in the First Affiliated Hospital of Kunming Medical College were analyzed retrospectively. Results Liver hanging tapes were placed successfully in 19 cases without related complications. Under the guidance of liver hanging tape,the IVC was protected well, and vessels of parenchyma in middle plane presented more clear. Conclusion With retrohepatic tunnel of the IVC of liver hanging maneuver, it can not only decrease hemorrhage but also shortten the operation time. The safety can be enhanced. The transection can be performed in a thinnest and smallest resection plane.