摘要
目的：总结应用Glisson蒂横断行解剖性肝段切除术的经验。方法：回顾性分析2010年9月至2014年9月医院采用Glisson蒂横断行解剖性肝段切除术86例患者的临床资料，其中胆囊癌8例、肝癌78例。采用Glisson蒂横断解剖性行右半肝切除（V＋Ⅵ＋Ⅶ＋Ⅷ段）5例，右肝前叶（V＋Ⅷ段）切除12例，左肝外叶（Ⅱ＋Ⅲ段）切除37例，左肝内叶（Ⅳ段）切除4例，左半肝（1I＋UI＋Ⅳ段）切除28例。结果：所有病例均成功实施Glisson蒂横断解剖性肝段切除术，术中无肝蒂Glisson鞘内管道损伤。手术平均时间4．8（3．2～8．5）h，平均失血量600（150～1200）mL，平均住院时间15．6（12～20）d。术后出现胆漏2例，出现胸腔积液4倒，均经引流、保守治疗痊愈出院，无死亡病例。
Objective:To summarize application of Glisson pedicle transaction method for anatomical liver resection Methods:A retrospective analysis of Glisson pedicle transection of liver had been carried out in 86 cases from September 2010 to September 2014 in the Central Hospital of Jingzhou.Among 86 cases,8patients had been diagnosed with cholangiocarcinoma while 78 primary hepatocellular carcinoma.Glisson pedicle transection had been carried out for anatomical liver resection,right hepatectomy(Ⅴ + Ⅵ + Ⅶ+ Ⅷsegment)in 5cases,anterior right pedicle resection(Ⅴ+ Ⅷsegment)in 12 cases,the left hepatic lobe(Ⅱ + Ⅲsegment)in 37 case,the left median segment(Ⅳsegment)in 4cases and the left liver(Ⅱ+ Ⅲ+Ⅳ segment)in 28 cases.Results:Glisson pedicle transection was successfully carried out.The average operative time was 4.8(3.2~8.5)hours,the average operative blood loss 600(150~1200)ml and the average hospital stay 15.6(12~20)days.After operation liver leakage occurred in 2cases,pleural effusion in 4cases.The patients were managed conservatively and discharged with no death case.Conclusion:Anatomical liver resection by application of Glisson pedicle transaction is simple,fast,safe and worthy of clinical application.
基金
湖北省医学领军人才培养工程专项经费资助(鄂卫生计生发[2013]4号文)
