第二肝门部肿瘤手术切除的经验体会

Surgery skills and experience of resection of second hilar tumor

目的:总结第二肝门部肿瘤手术切除经验。方法:对手术切除的137例第二肝门部肿瘤患者的临床资料进行回顾性分析,并结合文献资料进行总结。结果:137例手术切除及术中止血均获得成功。出现术后并发症30例(21.9%),包括术后出血7例,上消化道出血4例,胆汁瘘及膈下感染各3例,肝衰8例,肝性胸腔积液5例。因术后早期大出血、上消化道出血各死亡1例,肝衰死亡2例,肺转移肺梗塞、脑及脊髓广泛转移而放弃治疗各1例,围手术期死亡率4.4%(6/137)。结论:第二肝门部肿瘤是可以安全切除的。

OBJECTIVE： To summurise the resection experience of the second-hilar tumors. METHODS： The clinical data of 137 cases of the resection of the second-hilar tumors were retrospectively analyzed, and the related literature was reviewed. RESULTS： All operations of the whole group patients were successful. Thirty cases occured the postoperative complications and the complication rate was 21.9% （30/137）, including 7 cases of postoperative surgical field bleeding, 4 cases of upper gastrointestinal bleeding, 3 cases of biliary fistula, 3 cases of subphrenic abscess, 8 cases of liver functional compensation insufficiency, and 5 cases of hepatic hydrothorax. In the perioperative period, one case died for the early postoperative bleeding, one case for the upper gastrointestinal bleeding, two cases for liver failure, one case for pulmonary embolism due to lung metastases, and one case for the widespread brain and spinal cord metastases and giving up treatment. The total perioperative mortality was 4.4 % （6/137）. CONCLUSION： The resection of second hilar tumors is safe.