肝门区肿瘤手术并发症的防治

HOW TO PREVENT AND TREAT THE COMPLICATIONS WHILE RESECTING THE LIVER HILAR TUMORS

目的 探讨肝门区肿瘤的手术经验及并发症的防治。方法 对手术切除的 12 9例肝门区紧贴肝内大血管肿瘤的手术并发症进行总结分析 ,对其手术方法、经验教训及防治进行总结和讨论。结果 12 9例中发生手术并发症 2 1例 (16 .3% ) ,其中术中大出血、胆瘘、伤及健侧肝门、肝静脉及腔静脉回流受阻的发生率分别为 10 .1%、3.9%、0 .8%和 1.6 % ,无术中死亡。结论 虽然此类手术难度及风险性大 ,只要重视手术适应证的选择、手术操作和方法的改进 ,仍可提高手术安全性、防止并发症的发生。

Objective To study the experience of operation and methods to prevent and treat the complications while resecting the liver hilar tumors closs to the major hepatic vessels.Methods 129 cases with liver tumors tightly close to the major hepatic vessels were resected,and the operative complications were analyzed.The technique of surgery ,experience or lesson have been summarized and the ways of prevention and treatment of the operative complications have also been studied.Results The operative complications happened in 21 cases.The incidence of each complication including burst bleeding in operation,bile fistula,injury to the contralateral liver hila and posteroperative obstruction of hepatic vein and inferior vena cava was 10.1%、3.9%、0.8% and 1.6% respectively,and no one died in the surgery.Conclusion Although to perform this sort of surgery is quite difficult and risky,safety of the resection could be improved and the operative complications could be prevented and treated by paying attention to the choice of suitable cases and the improvement of surgical technique.