肝外确认、肝内处理切肝术式的临床研究

Clinical study on method of hepatectomy-extrahepatic recognition,intrahepatic management

目的 :在临床工作实践中 ,借鉴国内、国外先进的肝外科技术 ,探讨新的肝切除方法——“肝外确认 ,肝内处理”切肝法。方法 :应用“肝外确认 ,肝内处理”切肝法对 1 998年 1 2月～ 1 999年1 2月肝原发性恶性肿瘤患者中 40例成功地实行了肝切除术。结果 :40例患者中行右半肝切除 8例 ,肝右后叶切除 1 8例 ,肝左外叶切除 4例 ,左半肝 1例 ,右三叶切除 2例 ,左三叶切除 1例 ,肝段切除 6例。手术总时间 1 0 0～ 2 0 0 min,平均 1 2 0 min,术中出血量 50～ 50 0 ml,平均 1 50 ml。住院时间1 0～ 32 d,平均 1 3.5d。全组病人顺利康复 ,无手术死亡率。和同期采用切肝后血管处理法及不同时期切肝前血管处理法相比 ,具有术中出血少 ,手术时间短的优点。结论 :该方法安全、有效、实用 ,大大提高了肝癌的切除率 ,降低了术中出血的危险性 ,值得临床推广。

Objective: In clinical works , new method of hepatectomy “extrahepatic recognition, intrahepatic management” was studied Methods:Fourty patients of liver primary malignant tumor were operated successfully by this method from Dec,1998 to Dec,1999 Results:In these 40 cases ,right hemihepatectomy 8 cases, right posterior lobe resection 18 ,left lateral lobe resection 4,left hemihepatectomy 1,right trilobetectomy 2,left trilobetectomy 1 and segment resection 6 Operation time 100 200minutes,average 120minutes,bleeding 50~500ml,average 150ml Length of stay 10~32 days ,average 13 5 days In contrast with extrahepatic blood vessels management approach and intrahepatic blood vessels management approach ,this method has the advantage of less bleeding and time Conclusion: This method is safe, efficient and practical, moreover to improve the resection rate of liver cancer and decrease the danger of bleeding in the operation It is worth to advocate