肝脏海绵状血管瘤的手术指征和手术方法选择

Surgical indications and management for the hepatic cavernous hemangioma.

目的 探讨肝脏海绵状血管瘤的手术指征和手术方法。方法 回顾性分析采用手术治疗 39例肝脏海绵状血管瘤病人资料 ,判断其手术指征 ,评价不同手术方法的治疗结果及其手术并发症发生情况。结果 39例病人中 ,2 7例采用肝叶或肝段切除术 ,8例采用血管瘤摘除术、缝扎或结扎等方法 4例。 10例出现手术并发症 ,以胸腔积液和膈下积液多见。结论 对肝脏海绵状血管瘤最大径大于 5cm并有明显临床症状 ,或不能除外恶性肿瘤病人可以采用手术治疗。血管瘤摘除术和 2个或 2个以下肝段切除术是安全有效、并发症少的手术方法。

Objective To evaluate the surgical indications and various management for the hepatic cavernous hemangioma.Methods Thirty-nine patients with the hepatic cavernous hemangioma treated surgically were analyzed retrospectively to evaluate the surgical indications, the results of various operations and the operative complications. Results Twenty-seven patients underwent hepatic lobectomy or segmentectomy, eight patients were treated with the hemangioma enucleation. The operative complications occurred in 10 cases. The pleural effusions and subphrenic collection were the common complications.Conclusions Surgical management is indicated for the hepatic cavernous hemangioma more than 5 cm with obviously clinical manifestation,or uncertain diagnosis with a suspicion of malignancy. Hemangioma enucleation and hepatic segmentectomy equal to or less than 2 segments are the safe and effective surgical methods with less complications.