肝海绵状血管瘤包膜外剥离术26例临床分析

Surgical treatment of liver cavernous hemangiomas by enucleation:report of 26 cases

目的评价包膜外剥离术治疗肝海绵状血管瘤的方法。方法对48例需要手术治疗的肝海绵状血管瘤患者实施了手术,其中包膜外剥离术26例,腹腔镜下肝血管瘤切除7例,开腹肝叶切除术15例。结果实施包膜外剥离术的26例患者肝海绵状血管瘤均被完整剥除,手术平均出血200ml,术后并发症发生率26.9%(7/26),右侧胸腔积液4例,肝内血肿2例,切口感染1例,经对症治疗后痊愈。结论包膜外剥离术是治疗肝血管瘤的安全有效的方法。

Objective To evaluate the therapeutic effect of surgical enucleation on hepatic cavernous hemangioma.Methods From October 2005 to October 2010,48 patients underwent resection of hepatic cavernous hemangioma.Among them,7 patients received laparoscopic resection of cavernous hemangioma,15 liver resection laparotomy,and 26 enucleation（including hepatic arterial chemoembolization under interventional therapy before surgical therapy in 4 patients）.Results Cavernous hemangiomas were removed completely without intraoperative death.The average intraoperative blood loss was about 200 ml.Postoperative complications occurred in 7 of the 26 patients（26.9%）：pleural effussions on the right side in 4 patients,hepatic haematomas in 2,and infection of incisional wound in 1.Follow-up of the patients revealed no recurrence.Conclusions Enucleation of hepatic cavernous hemangiomas is safe and effective.Laparoscopic hepatectomy is indicated for some appropriate cases.