半离体肝切除余肝自体移植术治疗肝占位性疾病

Half Extracorporeal Hepatectomy and Autotransplantation of Residual Liver for Hepatic Space-occupying Lesions

目的总结半离体肝切除余肝自体移植术治疗肝占位性病变的体会。方法回顾性分析5例接受半离体肝切除余肝自体移植患者的临床资料,其中肝多发血管瘤2例,肝癌3例。结果5例患者术程顺利,术后未出现肝性脑病、肝创面大出血等严重并发症;术后平均11 d肝功能指标完全正常,术后10～26 d出院。1例随访20个月,肝功能正常且CT显示无肿瘤复发迹象,生活质量高;1例随访14个月,肝功能完全正常且无新发血管瘤;其余患者目前肝功能完全正常,各项情况稳定,已痊愈出院,尚在观察中。结论半离体肝切除余肝自体移植术是治疗常规手术无法切除的肝占位性病变的一种有效方法。

Objective To summarize the experience of half extracorporeal hepatectomy and autotransplantation of residual liver for hepatic space-occupying lesions.Method Clinical data was retrospectively studied in 5 patients with hepatic space-occupying lesions treated by half extracorporeal hepatectomy and hepatic autotransplantation,including 2 of angeioma and 3 of cancer.Results All the patients underwent the operation successfully without severe complications such as hepatic encephalopathy and hemorrhea.The liver function tests showed normal results within 11 days after operation and the patients were discharged at 10～26 days postoperatively.One patient has survived for 20 months and the liver function is normal without any sign of tumor recurrence.Another patient has survived for 14 months with the normal liver function without new angeioma.The other three patients were discharged with normal laboratory index.Conclusion Half extracorporeal hepatectomy and autotransplantation of residual liver is an effective approach for unresectable hepatic space-occupying lesions with routine method.