前入路肝切除技术探讨

STUDY OF SKILL OF ANTERIOR APPROACH FOR HEPATIC RESECTION

目的 探讨前入路肝切除术在难切性肝癌肝切除术中的应用价值。方法 对 2例用常规手术方法难以切除的肝右叶肝癌和 2例肝门部胆管癌用前入路的方法行肝切除 ,探讨其手术技巧和适应证。结果 2例右半肝切除 ,1例肝门部胆管加左半肝切除 ,1例肝门部胆管加尾状叶切除手术均获得成功。术中平均出血量 10 75 m l,手术至出院时间 12 .5 d。无手术死亡。

Objective To evaluate the anterior approach for the difficult hepatectomy.Methods The indications and operative techniques of the anterior approach hepatectomy were studied in two patients with the hepatocellular carcinoma of right lobe and two patients with the hilar cholangiocarcinoma,who were difficultly treated by the conventional approach hepatectomy.Results The anterior approach hepatectomies in all four cases were successful,including two right hemihepatectomies,one left hemihepatectomy with the resection of the hilar chloangiocarcioma,one caudate lobectomy with the resection of the hilar cholangiocarcioma.The mean intraoperative blood loss was 1075 ml.the postoperative hospital stay was 12.5 days.No death occurred.Conclusion The anterior approach hepatectomy is a safe and effective method to treat the patients with difficultly resectable hepatic cancer.