不阻断肝血流状态下左半肝切除术的临床前瞻性研究

Prospective clinical research of the left hemihepatectomy without hepatic Blood Inflow Occlusion

目的前瞻性分析研究不阻断肝血流状态下行左半肝切除术的临床可行性。方法 32例左半肝切除术患者随机分成AB两组:A组(n=16肝切除时阻断入肝血流);B组(n=16肝切除时不阻断入肝血流)。比较两组患者的相关临床及手术资料。结果两组患者在术中出血量、手术时间、并发症、术后住院天数等临床资料的差异无统计学意义;但不阻断肝血流组患者术后1、3天ALT、AST水平明显低于阻断肝血流组,有统计学差异。结论不阻断肝血流的左半肝切除术是一种安全、有效、可行的手术切除方法,但其总体疗效并不优于阻断肝血流。

Objective To investigate the safety and surgical technique of the left hemihepatectomy without hepatic blood inflow occlusion in a prospective randomized study of unselected patients. Methods 32 unselected patients undergoing the left hemihepatectomy were randomized into two groups ：The inflow was occluded in group A（ n = 16 ） and not occluded in group B （n = 16 ） during hepatectomy. The relative clinical data and operative factors between the two groups were compared. Results There were not statistically significant differences in intraoperative bloodloss, time for operation, complication and postoperative hospital stay, But in group B the levels of AST and ALT test 1 days and 3 days after operation were lower statistically than control group. Conclusion The left hemihepatectomy without hepatic blood inflow occlusion is safe , effective and feasible, then it is no better than that with inflow occlusion.