包括腔静脉旁部的肝尾叶切除术

Resection of right or total hepatic caudate lobe including paracaval portion

目的 探讨并总结包括腔静脉旁部肝尾叶切除的方法和经验。 方法 分别采用右后途径和左侧途径行肝右尾叶和全尾叶切除 ;前者附加部分右后叶切除 ,后者可为单独全尾叶切除或附加左外叶或左半肝切除。 结果 成功施行包括腔静脉旁部的肝尾叶切除 13例 ,其中右尾叶切除 7例 ,全尾叶切除 6例 ;全组无手术死亡 ,术中、术后均无严重并发症发生 ;术中平均失血量为 896 15ml,平均肝门阻断时间为 2 5 4min ,术后平均住院 12d。 结论 虽然肝门部解剖关系复杂 ,但手术切除包括腔静脉旁部的肝尾叶仍是安全可行的。

Objectives To evaluate the surgical techniques and feasibility for resecting the hepatic caudate lobe including the paracaval portion. Methods Right posterior approach for right caudate lobectomy and left lateral approach for total caudate lobectomy were taken with or without some kinds of preparatory segmentectomies. Results Seven right and 6 total caudate lobectomies, all including paracaval portion, ware accomplished without operative death. The mean intraoperative blood loss was 896 15(250-2 000) ml and the mean portal triad clamping time was 25 4(10-83) min. The postoperative course was uneventful for all the cases, and the mean hospital stay was 12(9-22) days. Conclusions Athough being complicated anatomically, resection of the hepatic caudate lobe including the paracaval portion is feasible with a high safety.