原发性肝癌合并门脉高压症的外科治疗

Surgical Treatment for Primary Liver Carcinoma with Portal Hypertension

目的探讨原发性肝癌合并门脉高压症的一期联合手术治疗的可行性和适应证。方法回顾性分析30例原发性肝癌合并门脉高压症行手术治疗的病人,其中24例附加贲门周围血管离断术加脾切除术6,例行脾切除术,其中肝切除范围:26例行不规则肝切除及4例行规则性左半肝切除术。结果术后均无手术死亡,术后黄疸、腹水及消化道出血等并发症在出院时消退,脾亢症状明显缓解。结论肝癌合并门脉高压症行肝切除或脾切除及断流手术是一种安全可行的方法,有利于提高病人远期生存率。

Objective To discuss the effect and indication of synchronous hepatectomy and splenectomy for HCC patients with portal hypertension. Methods The clinical data of 30 patients with HCC and portal hypertension were analyzed retrospectively. Hepatectomy and splenectomy were performedin30 patients,including pericardiac devascularizasion in 24 patients. Six patients were treated by spleneetomy. Among them 26 patients were treated by irregular hepatectomy and 4 by regular hepatectomy of left half liver. Results All patients survived.Within serval days of operation,the hypersplenism disappeared, the platelet count were found to be significantly elevated. Conclusion Synchronous splenectomy can increase the safety of hepatectomy in patients with HCC. Splenectomy benefits the patient＇s forward exist rate.