肝移植治疗肝脏良性肿瘤六例临床分析

Liver transplantation for benign liver tumor： six cases report and literature review

目的分析探讨肝移植治疗肝脏良性肿瘤的适应证和疗效。方法回顾2001年1月至2014年12月天津市第一中心医院肝胆外科对6例良性肝脏肿瘤的患者实施的肝移植术患者资料，其中男3例，女3例；2例为肝脏上皮样血管内皮瘤，1例为肝脏海绵状血管瘤，1例为肝脏间质错构瘤，1例为肝门部胆管黏液性囊腺瘤，1例为肝脏腺瘤。对患者的手术方式，围手术期并发症，术后管理及随访结果进行了分析。结果6例均行原位肝移植术，1例为活体供肝，其余为尸体供肝。1例围手术期死亡，其余5例患者围手术期全部存活并且肝肾功能正常出院，术后随访22～88个月，存活至今，患者移植物功能基本正常，营养状况明显改善，均可以进行正常的工作或社会活动。结论对于不能切除症状明显的肝脏良性肿物，肝移植可以作为一种最有效的治疗手段，预后良好。

Objective To analyse and explore the indications and efficacy of liver transplantation for benign liver tumor. Methods From Jan. 2001 to Dec. 2014, 6 patients, incluing 3 males and 3 females, with benign liver tumor underwent liver transplantation in our department. There were 2 cases of hepatic epithelioid hemangioendothelioma, 1 case of hepatic cavernous hemangioma, 1 ease of liver mesenchymal hamartoma, 1 case of hilar bile duct mucinous cystadenoma, and 1 case of hepatic adenoma. The data of surgical procedure, perioperative complications, postoperative management, and the outcome of follow-up were analyzed. Results Six orthotopic liver transplantation from one living donor and five cadaveric donors were performed. One patient died in the perioperative period, and other patients were discharged with normal liver and kidney function. Within the follow-up time of 22 to 88 months, these patients could live the normal lives with stable graft function and nutritional status. Conclusions Liver transplantation is the most efficient treatment for unresectable and symptomatic benign lesions, with the favourable outcome.