中肝叶巨大原发性肝癌的手术切除

Resection of giant primary liver carcinoma in the middle lobe of liver

目的 探讨中肝叶巨大肝癌的手术切除技术。方法 回顾性分析 1996年 10月至 2 0 0 1年 12月施行肝切除术的 16 6例中肝叶巨大肝癌的术中处理、术后并发症及原因。结果 全组均为常温间歇性第一肝门阻断下切肝 ,单例总阻断时间最长 6 8min ,最短 7min ,平均 2 4 .5min ;输血量最多为5 2 0 0ml,5 4例未输血 ;肿瘤切除 12 3例 (74 .1% ) ,规则性肝叶切除 4 3例 (2 5 .9% ) ;术后并发症 9例(5 .4 % ) ,手术死亡 2例 (1.2 % )。结论 术前良好的肝功能储备是保证中肝叶巨大肝癌手术切除术后顺利恢复的首要条件 。

Objective To investigate the surgical technique of resection of giant primary carcinoma in the middle lobe of liver. Methods The intraoperative manipulation, postoperative complications and their causes of excision of giant primary hepatic carcinoma in 166 patients between October 1996 and December 2001 were analysed retrospectively. Results With clamping the first porta hepatis at room temperature, hepatectomy were done in all patients. The longest and shortest of total clamping period were 68 minutes and 7 minutes, and the average were 24.5 minutes. The maximum of blood transfusion was 5 200 ml, and no transfusion needed in 54 cases. Intact tumor excision was done in 123 cases, and regular lobectomy of liver was done in 43. Postoperative complications happened in 9 patients (5.4%), and 2 of the 9 patients them died (1.2%). Conclusions For patients, successful recovery, the satisfactory liver reserve function before operation is essential. To reduce postoperative complications, intraoperative careful manipulation is the key point.