伴活动性肝炎的肝细胞癌围手术期处理

Perioperative management of patients with hepatocellular carcinoma accompanied by active hepatitis

目的 探讨伴活动性肝炎的肝细胞癌的可切除性和安全性。方法 2 6例伴活动性肝炎的肝细胞癌 ,平均肿瘤直径 7 7cm ,经术前短期护肝治疗后行肝肿瘤切除术 ,术后继续护肝治疗。结果 2 6例肝癌均得到顺利切除 ,最常见的并发症为一过性肝功能损害 ,无手术死亡和严重并发症 ,平均手术时间 65min ,平均出血量 3 2 8ml。结论 伴活动性肝炎的原发性肝癌的手术切除虽有一定的挑战性 ,只要围手术期处理得当 。

Objective To investigate the feasibility and safety of resection of hepatocellular carcinoma (HCC) accompanied by active hepatitis (AH). Methods Twenty six patients with HCC (mean diameter = 7 7 cm) accompanied by AH were surgically treated. After the operation, the patients were continuously treated to improve the liver function. Results The tumor was successfully resected in all the 26 patients. There were no serious complications and postoperative mortality or morbidity. The mean operative duration was 65 min and the mean blood loss 328 ml. Conclusions It is feasible and safe to resect HCC accompanied by AH if proper perioperative management is performed.