肝门部Glisson蒂右前支血流阻断行肝右后叶解剖性肝切除术

The Dissection Hepatectomy of Porta Hepatis Glisson Pedicle Right Front Branch Blood Flow Interdict Liver Right Rear

目的探讨肝门部Glisson蒂右前支血流阻断行肝右后叶解剖性肝切除术在肝癌手术中的应用。方法回顾性分析17例肝右后叶肝癌患者的临床资料,9例采用肝门部Glisson蒂右前支血流阻断行肝右后叶解剖性肝切除术(A组);8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。结果两组病例均无死亡病例,A组术中出血量、术后第1、3、5、7 d的血清谷丙转氨酶(Alanine Transaminase,ALT)低于B组,P<0.05,差异具有统计学意义。结论肝门部Glisson蒂右前支血流阻断行肝右后叶解剖性肝切除术是减少术中出血、减少术后肝功能损害的有效的肝切除方法。

Objective To explore the applications of anatomy resection of right posterior lobe of liver through hilar Glisson pedicle occlusion blood lfow of right anterior branch with Glisson sheath in the hepatic carcinoma surgery. Methods Selected 17 cases of right posterior lobe of hepatic cancer patients clinical data were retrospectively analyzed. The resection of liver with right posterior lobe of liver through hilar Glisson pedicle occlusion blood lfow of right anterior branch with Glisson sheath have nine cases（group A）.The focal resection of hepatic carcinoma using intermittent Pringle maneuver have eight cases（group B）. Two groups of bleeding, postoperative liver function were compared. Results Two groups were no deaths;A group blood loss, postoperative 1, 3, 5, 7 days of serum alanine aminotransferase（alanine transaminase, ALT）was lower than group B;P〈0.05, had difference statistically signiifcance. Conclusion The technique that anatomy resection of right posterior lobe of liver through hilar Glisson pedicle occlusion blood lfow of right anterior branch 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.