• 復(fù)旦大學(xué)肝癌研究所、復(fù)旦大學(xué)附屬中山醫(yī)院肝外科(上海200032);

目的  總結(jié)行解剖性肝切除的經(jīng)驗(yàn)及結(jié)果。
方法  2004年1月至2005年6月期間,我們對(duì)93例肝細(xì)胞癌患者進(jìn)行解剖性肝切除,對(duì)相應(yīng)外科技術(shù)進(jìn)行改進(jìn)以減少術(shù)中出血、輸血及術(shù)后并發(fā)癥。切肝采用血管鉗鉗夾肝組織,暴露肝內(nèi)管道后再結(jié)扎,選擇性阻斷出、入肝血流; 對(duì)13例巨大腫瘤行半肝切除時(shí)采用肝臟懸吊法,切肝時(shí)采用間斷Pringle法阻斷肝門。
結(jié)果  93例肝癌患者中82例(88%)伴有不同程度的肝硬變,平均出血量300 ml (100~6 000 ml),71%(66/93)病例不需輸血。術(shù)后并發(fā)癥發(fā)生率為34%(32/93),膈下積液多發(fā),共8例。術(shù)后30 d 內(nèi)無(wú)手術(shù)死亡。
結(jié)論  解剖性肝切除可能提高手術(shù)療效。

引用本文: 王魯,孫惠川,欽倫秀,葉青海,任寧,馬曾辰,吳志全,樊嘉,湯釗猷. 肝癌解剖性肝切除的初步經(jīng)驗(yàn). 中國(guó)普外基礎(chǔ)與臨床雜志, 2007, 14(1): 39-41. doi: 復(fù)制

版權(quán)信息: ?四川大學(xué)華西醫(yī)院華西期刊社《中國(guó)普外基礎(chǔ)與臨床雜志》版權(quán)所有,未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

1.  Healey JE Jr, Schroy PC. Anatomy of the biliary ducts within the human liver; analysis of the prevailing pattern of branchings and the major variations of the biliary ducts [J]. AMA Arch Surg, 1953; 66(5)∶599.
2.  Takasaki K. Glissonean pedicle transection method for hepatic resection: a new concept of liver segmentation [J]. J Hepatobiliary Pancreat Surg, 1998; 5(3)∶286.
3.  Makuuchi M, Hasegawa H, Yamazaki S. Ultrasonically guided subsegmentectomy [J]. Surg Gynecol Obstet, 1985; 161(4)∶346.
4.  Belghiti J. Systematic hepatectomy for liver cancer [J]. J Hepatobiliary Pancreat Surg, 2005; 12(5)∶362.
5.  Matsushima T, Kanematsu T, Takenaka K, et al. Pattern of intrahepatic recurrence after curative resection of hepatocellular carcinoma [J]. Hepatology, 1989; 9(2)∶457.
6.  Kosuge T, Makuuchi M, Takayama T, et al. Longterm results after resection of hepatocellular carcinoma: experience of 480 cases [J]. Hepatogastroenterology, 1993; 40(4)∶328.
7.  Fan ST, Lai EC, Lo CM, et al. Hospital mortality of major hepatectomy for hepatocellular carcinoma associated with cirrhosis [J]. Arch Surg, 1995; 130(2)∶198.
  1. 1.  Healey JE Jr, Schroy PC. Anatomy of the biliary ducts within the human liver; analysis of the prevailing pattern of branchings and the major variations of the biliary ducts [J]. AMA Arch Surg, 1953; 66(5)∶599.
  2. 2.  Takasaki K. Glissonean pedicle transection method for hepatic resection: a new concept of liver segmentation [J]. J Hepatobiliary Pancreat Surg, 1998; 5(3)∶286.
  3. 3.  Makuuchi M, Hasegawa H, Yamazaki S. Ultrasonically guided subsegmentectomy [J]. Surg Gynecol Obstet, 1985; 161(4)∶346.
  4. 4.  Belghiti J. Systematic hepatectomy for liver cancer [J]. J Hepatobiliary Pancreat Surg, 2005; 12(5)∶362.
  5. 5.  Matsushima T, Kanematsu T, Takenaka K, et al. Pattern of intrahepatic recurrence after curative resection of hepatocellular carcinoma [J]. Hepatology, 1989; 9(2)∶457.
  6. 6.  Kosuge T, Makuuchi M, Takayama T, et al. Longterm results after resection of hepatocellular carcinoma: experience of 480 cases [J]. Hepatogastroenterology, 1993; 40(4)∶328.
  7. 7.  Fan ST, Lai EC, Lo CM, et al. Hospital mortality of major hepatectomy for hepatocellular carcinoma associated with cirrhosis [J]. Arch Surg, 1995; 130(2)∶198.