联合手术治疗原发性肝癌并肝硬化门脉高压症18例

Combined operative treatment primary hepatoma complicated by hepatic cirrhosis and portal hypertension

目的 探讨肝肿瘤切除术联合门奇静脉断流术治疗原发肝癌并肝硬化门脉高压症的临床疗效。方法 肝肿瘤切除手术完成后 ,再行脾切除或脾动脉结扎、胃冠状静脉离断术。结果 手术均获成功 ,无死亡病例 ,经 1a以上随访 12例 ,均无呕血及黑便。结论 该术式具有 1次手术治疗 2种疾病的优点 ,术前肝功能评估和准备。

Objective To evaluate the clinical effectiveness of hepatic tumour excision combined with portoazygos devascularization in treating primary hepatoma complicated with hepatic cirrhosis and portal hypertension.Methods Splenectomy or ligation of splenic artery and disjunction of vena coronaria ventriculi were performed after completion of hepatic-tumour excision.Results All operations succeeded.12 cases were followed up over one year.None of 12 Cases was death,hematemesis or passage of tarry stools.Conclusions The combined operation can treat two diseases in one operation.The important factor of success resides in preoperative assessment of liver function,preparation,and correct choice of mode in the operation.