单独全尾状叶肝切除术14例临床经验

Isolated complete resection of hepatic caudate lobe：a clinical experience of 14 patients

目的：总结单独全尾状叶肝切除术治疗肝尾状叶肿瘤的临床经验。方法回顾性分析我院2007年12月－2015年3月行单独全尾状叶肝切除的14例肝尾状叶肿瘤患者的临床资料。术中游离左右肝，预置肝上、肝下下腔静脉和区域性出入肝血流阻断带，行左入路、右入路、联合左右入路、中央入路或逆行单独全尾状叶切除。结果手术时间为（227±64） min，失血量为（530±325） ml，血流阻断时间为（19．5±18．6） min，肿瘤直径为（15．4±9．2） cm。手术均顺利完成。术后出现胸水3例、腹水2例，经治疗后痊愈，无大出血和胆漏等并发症，无围手术期死亡。平均住院时间为（21±9） d，均痊愈出院。结论选准指征、充分显露、减少血流阻断时间可使单独全尾状叶肝切除术手术具有可控性、可行性和实用性。

Obj ective To summarize the clinical experience with isolated complete resection of he-patic caudate lobe in 14 patients. Mte hods The clinical data of 14patients with isolated complete resection of hepatic caudate lobe carried out in our hospital from December 2007 to March 2015 were retrospectively analyzed .During the operation , selective hepatic vascular occlusion slings , and supra-and infra-hepatic in-ferior vena cava slings were placed after full mobilization of the liver .Isolated complete resection of the he-patic caudate lobe was performed through the left and /or the right , the anterior liver-splitting or the retro-grade approaches .Results The mean operation time was （227 ±64） min.The mean amount of blood loss was （530 ±325） ml.The mean vascular occlusion time was （19.5 ±18.6） min.The mean diameter of ne-oplasm was （15 4.±9 .2） cm. All the operations were successfully carried out .There were no massive hem-orrhage, bile leakage or perioperative death .Hydrothorax occurred in 3 patients and ascites in 2.The mean stay in hospital was （21 ±9） days.All the patients were cured and discharged home .Conclusion Isolated complete resection of hepatic caudate lobe was feasible in clinical practice .