肝切除69例临床分析

CLINICAL ANALYSIS OF 69 CASES HEPATECTOMY

目的 对各类肝切除术的有关问题进行探讨 ,总结肝脏恶性肿瘤及良性病变的手术适应证。方法 对半肝以上的肝切除 ,解剖肝门、行单侧入肝血管结扎或半肝血流阻断 ,对于肝叶或联合肝段切除行第一肝门血流阻断 (Pringle法 )或手控法。恶性病变切肝时 ,距肿瘤边缘肝组织 2 cm以外切除 ,保留硬变肝的 5 0 %或正常肝的 30 %。结果 术中大出血 1例 ,无手术死亡 ,恶性病变 40例 ,1、3、5年存活率分别为 5 5 .0 %、40 .0 %、5 .0 % ,良性病变肝切除愈后良好。结论 在控制入肝血流下 ,以钳夹法为主的切肝实用、简便、可靠。

Objective To discuss related problems of hepatectomy and summarize operation indications to malignant tumor and benign diseases of liver.Methods In operation about range larger than hemihepatectomy,dissecting hepatic portal,ligating unilateral hepatic vessels and interrupting hemihepatic blood flow were done.For removing liver lobe or associated segments,interrupting blood of the first hepatic portal with Pringle method or manual control was done.Amputation site of malignant tumor was outside 2 cm around tumor edge,50% cirrhosis tissue or 30% normal liver tissue were remained.Results 1 case had massive hematorrhea in operation,no dead case occurred in operation.In 40 cases with malignant tumor,the 1,3,5 years survival rates were 55%,40% and 5% respectively.Hepatectomy was good to liver benign diseases.Conclusion If the blood flow of entering liver is under control,hepatectomy in forcipressure is practical,simple,reliable.The perioperative treatment is by far the most important.