腹腔镜辅助经皮超声引导肝肿瘤射频消融术的临床应用

探讨腹腔镜辅助经皮超声引导射频消融术在处理特殊位置肝肿瘤中的应用效果。回顾分析2016年6月—2017年1月北京医院肝胆胰外科符合入组标准的患者资料。共纳入15例,男8例,女7例;平均年龄(63.5±6.7)岁。单发病灶12例,多发3例,共消融肿瘤19枚,Ⅷ段肝裸区7枚,VII段肝裸区5枚,Ⅵ、Ⅶ段间突向膈肌1枚,Ⅴ段、Ⅳ段突向肝脏面与横结肠或十二指肠关系密切3枚,IV段膈顶第二肝门旁1枚,Ⅲ段外生与胃粘连1枚,I段下腔静脉旁1枚。肿瘤大小0.5~3.0 cm,平均(1.78±0.79)cm,有4枚消融2次,每次12 min,其余15枚均消融一次,每次12 min。以单发病灶计算,平均手术时间(94.4±17.6)min。术后住院天数3~6 d,中位时间4 d。术后无出血、感染、肝功能不全等并发症。1个月影像随访有1例VIII段消融灶近膈肌处消融不完全(1/19,5.2%)。腹腔镜辅助经皮超声引导射频消融术对于处理特殊位置肝肿瘤具有可行性、安全性及有效性。

Hepatic ectopic pregnancy treated successfully by hepatectomy

Hepatic ectopic pregnancies are extremely rare and .can be associated with excessive maternal morbidityand mortality.1 Given the rarity of such a form of ectopic pregnancy and the associated potential mortality, early diagnosis and appropriate treatment is essential. We present a unique case of an ectopic pregnancy with a 1 O-week-old fetus implanted on the liver, which was treated successfully by hepatic resection.