损伤控制非规则性肝叶切除在外科临床中的应用

CLINICAL APPLICATION OF IRREGULAR LIVER RESECTION OF THE TECHNIQUE OF DAMAGE CONTROL

目的为提高肝内胆管结石、原发性肝癌肝叶切除水平及探讨肝脏损伤控制技术的临床应用。方法回顾分析近16年来我院101例肝内胆管结石、原发性肝癌等,除4例肝癌行规则性左半肝切除外,其余均采用非规则性肝叶切除。结果切口感染5例;肺部感染3例;膈下感染2例;胆瘘1例;高位空肠瘘1例,经非手术治疗后痊愈,1例死于肝功能衰竭。结论非规则性肝叶切除降低了手术损伤程度及手术难度,减少了手术风险、手术并发症及死亡率,取得良好的效果。

Objective To improve the level of hepatic lobectomy of hepatolithiasis, primary liver cancer, hemangionma of liver and to explore the application of the technique of damage control. Methods Among the 101 cases of hepatolithiasis, primary liver cancer, hemangionma of liver, etc in recent 16 years in our hospital, 4 patients adopted regular left liver resection, the rest adopted irregular hepatic lobectomy. Results 5 patients suffered from notch infection, 3 lung infection, 2 uncler diaphragm, 1 biliary fistulas , 1 high position jejunum fistula, of whom one died of liver failure and the rest recovered after conservertive treatment. Conclusion irregular hepatic lobectomy reduced the difficulty of operation, and the risk , complications and the death rate were decreased as well. The same result was gained with regular hepatic lohectomy