复杂肝切除术安全性及有效性今日观

Current trends of liver resection techniques towards safety and effectiveness of complicated and major hepatectomy

随着外科技术及设备的进步,越来越多复杂的肝切除术被实施,越来越多的肝切除病人从中受益。活体肝移植手术的成功施行使供者安全无恙,使受者接受了高质量的供肝,是复杂肝切除手术的精彩体现。作为病人的肝切除术难度随着疾病的复杂性增加也逐日被克服。与此同时,也发现有的病人经历了复杂的手术是否安全度过围手术期?即使安全度过围手术期,术后效果是否满意?这些都提示外科医生要认真掌握手术适应证,认真地术前评估及准备。术中精细操作达到今日提倡的精准肝切除术的水平,是至关重要的。

More and more complicated and major hepatectomies have been performed with rapid improvements of surgical techniques and equipments in the last several decades. As a result, many patients recovered from some liVer diseases following Such major and complicated surgery. On one hand, living donor liver can be received safely for the donor. On the other hand, the receipt has possibility to get high quality donor organ and to survive even longer with dramatically good function of transplanted liver. In this way, surgeons are now encouraged to face with and deal with more challenges of complicated hepatectomy. However some patients do not have good postoperative outcome sometimes, even die earlier than preoperatively respected. It suggests that the safety and effectiveness should be simultaneously considered. Safety is more vitally important undoubtedly, otherwise even more major and successful operation is nothing else. Precise hepateetomy plays an important role in making the balance between safety and effectiveness.