单独肝尾状叶切除术策略更新(附21例报告)

The update strategy of the isolated caudate lobe resection:A report of 21 cases

目的探讨单独尾状叶切除术的方法和策略。方法回顾性分析2009年1月至2013年12月上海交通大学医学院附属新华医院普外科和浙江大学医学院附属第二医院普外科收治的21例行单独尾状叶切除术病人的临床资料,其中尾状叶原发性肝癌7例,结直肠癌肝尾状叶转移5例,肝尾状叶血管瘤9例;均按将尾状叶从4个相邻界面分离的方式进行手术。结果 21例病人均顺利完成手术,无死亡病例,平均手术时间为(261.2±52.6)min,平均失血量为(683.1±317.3)mL,平均住院时间为12 d。术后1例出现腹水,其余无术后并发症。结论围绕着将尾状叶从4个界面分离的方式,有助于进行单独肝脏尾状叶切除术。

Objective To explore the method and strategy of isolated caudate lobe resection. Methods The clinical data of 21 cases of isolated caudate lobe resection performed from January 2009 to October 2013 in Department of General Surgery,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Department of General Surgery, the Second Affiliated Hospital of Zhejiang University School of Medicine were analyzed retrospectively. All the cases underwent caudate lobe resection by detaching from its four boundaries including 7cases of the primary hepatocellular carcinoma,5 cases of metastasis from colorectal cancer and 9 cases of hepatic hemangioma. Results All cases were successful. The mean operative time was（261±52）min. The mean blood loss was（683±317）mL. The mean postoperative hospital stay was 12 days. Postoperative complication included only 1case of ascites. Conclusion The method by detaching caudate lobe from its four boundaries is useful in the resection.