紧邻下腔静脉的肝血管瘤13例的外科手术治疗

Surgical treatment for huge hepatic cavernous hemangioma closely attached to inferior vena cava

目的 总结本院 3年中对经病理学检查确诊的 13例紧邻下腔静脉巨大肝海绵状血管瘤的外科手术经验。方法 断肝时均采用间歇性入肝血流阻断 ,每次 10min间歇 2min。最长总阻断时间 180min而术后肝功能未受影响。用PMOD刮吸法断肝 ,切除肿瘤。结果 有 2例瘤体大面积与膈肌紧贴并有许多血管相交通造成术中大出血 ,出血量达 80 0 0～ 110 0 0ml,均经填塞止血治愈。其余 11例出血量在 6 0 0ml以下。结论 间歇入肝血流阻断 ,可使总阻断时间延长 ,为施行高难度肝切除创造有利条件。

Objective[WT5”BZ] To review the surgical treatment of 13 cases with huge hepatic cavernous hemangioma(HCH) closely attached to inferior vena cava(IVC).[WT5”HZ]Methods[WT5”BZ] During parenchymal transection,the hepatic inflow blood were intermittently occluded for 10 minutes on each session, with 2 minutes interval.The longest total vessel occlusion time was 180 minutes without postoperative detrimental effect on hepatic function.HCH was resected successfully with the application of curettage and aspiration technigue (CAT).[WT5”HZ]Results[WT5”BZ] Blood loss and transfusion were less than 600?ml each in 11 cases.In 2 cases the blood loss reached 8?000 and 11?000?ml respectively, due to severe vascular adhesion between HCH and diaphragm.Tamponade was applied in these two cases successfully to control the bleeding.[WT5”HZ]Conclusion[WT5”BZ] Intermittent hepatic blood inflow occlusion performed in our way lent itself to maximum preservation of postoperative liver function. [WT5”HZ]