选择性肝门阻断肝叶切除术治疗60例肝占位性病变

Selective hepatic lobectomy and segmental resection of liver for liver tumors: A report of 60 cases

目的:探讨选择性肝门阻断肝叶切除术的临床疗效。方法:对 6 0例肝占位性病变患者 (肝癌、胆管癌、肝血管瘤、肝包虫病等 )行选择性肝门阻断法肝切除 ,对病变大小、位置、术前、术后肝功能及术中出血量、术后并发症进行分析。结果:5 6例术后恢复良好 ,未出现出血、胆漏、感染等并发症 ,平均住院 13.5 d。术后 1例因肝功能衰竭死亡 ,3例出现反应性胸腔积液。结论:与全肝肝门阻断法相比 ,选择性肝门阻断法行肝切除术出血少并便于控制 ,对肝脏损伤小 。

Objective: To investigate curative effects of hepatectomy, lobectomy and segmentectomy for different tumors in liver. Methods: Sixty patients suffered from liver tumors underwent hepatectomy, lobectomy and segmentectomy between 1997 and 2002 by using selective hilar blocking procedure. Clinical effect was analysed, based on location and size of the lesion, comparison of liver function, bleeding volume and post surgical complications. Results: 56 patients recovered smoothly without major complications, such as biliary fistula, hemobilia, subdiaphragmatic and resectional surface infections. One died of liver functional failure, 3 occurred hydrothorax, average in patient was 13.5 days. Conclusions: selective hilar blocking procedure causes less blood loss and easier control of bleeding during operation compared to damage than Pringle's maneuver; this method demonstrated less liver damage and quicker recovery.