肝切面不缝合＋预防性“T”管引流在肝癌切除中的应用

Application value of directly opened liver section and the drainage of preventive T tube in hepatectomy for liver cancer

目的探讨肝癌切除术中减少肝功能损害、胆漏的手术方法。方法选择2004年6月至2012年6月肝癌切除术97例，其中传统肝切面褥式缝合50例（缝合组），肝切面不缝合＋预放性“T”管引流47例（开放组），对比分析手术时间、术后发热、WBC、转氨酶、胆红素、血性引流液及胆汁漏情况。结果手术时间、血性引流液比较差异无统计学意义（P〉0．05），而发热时间、wbc升高时间、转氨酶升高时间、胆红素升高时间、胆漏均明显少于缝合组（P〈0．05）。结论肝切面不缝合＋预放性“T”管引流在肝癌切除术中减少胆汁漏、肝功能损害方面有一定的积极意义。

Objective To investigate the surgical methods to reduce liver dysfunction, the bile leakage after liver cancer surgery. Methods 97 cases of hepatectomy were selected from June 2004 to June 2012, among them, 50 cases used traditional mattress-suture of liver section （the suture group）, 47 cases used directly opened liver section and drainage of preventive T tube （the open group）, comparatively analyzed the operative time and postoperative fever, the WBC, transaminases, bilirubin, bloody drainage fluid and bile leakage. Results Operative time and bloody fluid drainage were not statistically significant different （P〉0.05）, while the duration of fever, elevated time of WBC, elevated time of transaminase, elevated time of bilirubin time, bile leakage were significantly less than those of the suture group （P〈0.05）. Conclusion Directly opened liver section and drainage of preventive T tube plays certain positive role of reducing bile leakage and liver dysfunction in hepatectomy for liver cancer.