肝癌合并门静脉高压症的同期联合手术治疗(附19例报告)

Combined surgical procedure for patients with hepatocellular carcinoma and portal hypertension

目的 肝癌合并门静脉高压症同期联合手术治疗的方法和疗效。方法 回顾性分析1994年 8月至 2 0 0 2年 2月施行肝癌和门静脉高压症同期联合手术治疗 19例。结果 除 1例于术后 4周因并发肝肾综合征及上消化道出血死于多器官功能衰竭 (手术死亡率 5 .2 6 % )外 ,其余 18例皆康复出院 ,术后并发症发生率为 4 .1% (8 19)。随访中死亡 11例 ,死亡原因 :肝癌复发 3例 ,肝功衰竭 5例 ,上消化道出血 3例。术后 1、2、3年生存率分别为 79.8%、2 8.6 %、0 %。结论 只要合理掌握手术适应证和术式 ,对肝癌合并门静脉高压症施行同期联合手术治疗是安全的 。

Objective To discuss the method and effect of combined operation for patients with hepatocellular carcinoma and portal hypertension. Methods Retrospective analysis of one stage surgical procedure was performed in 19 cases in our department from Aug. 1994 to Feb. 2002. Results Operative mortality and complication rate was 5.26%and 42.1%(8/19) respectively. The postoperative survival rate of 1, 2 and 3 years was respectively 79.8%, 28.6% and 0%. 11 patients died during follow-up period including cancer recurrence in 3, liver failure in 5, variceal bleeding in 3. Conclusions The survival time can be prolonged and the postoperative complication reduced by prudent selecting of surgical procedures in patients suffering from concurrent hepatocellular carcinoma and portal hypertension.