肝门部Glisson蒂交替血流阻断循Glisson鞘行肝右前叶下段解剖性切除术

Applications of anatomy resection of right anterior lobe inferior section of liver through hilar Glisson pedicle alternately occlusion blood flow with Glisson sheath

目的探讨肝门部Glisson蒂交替血流阻断、循Glisson鞘行肝右前叶下段解剖性切除在肝癌手术中的应用。方法 15例肝右前叶下段肝癌患者中,8例采用肝门部Glisson蒂交替血流阻断、循Glisson鞘行肝右前叶下段解剖性切除术(A组)。7例采用间歇性第一肝门阻断(B组)行肝肿瘤局部切除术。对两组术中出血、术后肝功能情况进行比较。结果两组均无死亡病例,A组术中出血量、术后第1、3、5、7天的血清谷丙转氨酶(alanine transaminase,ALT)明显低于B组,两组比较差异具有统计学意义(P<0.05)。结论肝门部Glisson蒂交替血流阻断、循Glisson鞘行肝右前叶下段解剖性切除术是减少术中出血和术后肝功能损害的有效的肝切除方法。

Objective The applications of anatomy resection of right anterior lobe inferior section of liver through hilar Glisson pedicle alternately occlusion blood flow with Glisson sheath was discussed in the hepatic carcinoma surgery. Methods The clinical data what is 15 ea- ses of right anterior lobe of hepatic cancer patients were retrospectively analyzed. The resection of liver with right anterior lobe inferior section of liver through hilar Glisson pedicle alternately occlusion blood flow with Glisson sheath have eight cases（ A group）. The focal resection of hepatic carcinoma using intermittent Pringle occlusion have seven cases （ B group）. Two groups of bleeding, postoperative liver function were compared. Results Two groups were no deaths; A group blood loss, postoperative 1,3,5,7 d of serum alanine aminotransferase （alanine transaminase, ALT） was significantly lower than group B ; the difference of two groups was statistically significant （ P 〈 0.05 ）. Conclusion The technique that anatomy resection of right anterior lobe inferior section of liver through hilar Glisson pedicle alternately occlusion blood flow with Glisson sheath was a effective method of hepatic resection as decreasing blood loss and reducing the injure of hepatic function in the hepatic surgery.