经肝后下腔静脉前间隙入路行巨大肝癌切除：附38例  

Resecting large hepatocellular carcinoma through retrohepatic tunnel： a report of 38 cases

作　　者：李森[1] 庄冠一[1] 李春友[1] 杜福田[1] 丁伟[1] 董承伟[1] 郭玉林[1] 宋钦华[1] 

机构地区：[1]山东省潍坊市人民医院肝胆外科,261041

出　　处：《中华肝胆外科杂志》2009年第4期259-261,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨巨大肝癌的可切除性及切除方法的改进。方法回顾性分析2003年5月至2006年12月潍坊市人民医院肝胆外科手术切除的38例巨大肝癌资料。38例巨大肝癌平均直径14．4cm（10．5-27cm），术中先行结扎患侧肝动脉及门静脉，解剖打通肝后下腔静脉前间隙，在绕肝带捆扎指示下前入路法逆行切除瘤体。结果38例手术均取得成功，平均出血量850ml（300-2700ml），围手术期无死亡。1、2、3年生存率分别为78．9％、57．9％、39．5％。结论巨大肝癌非手术禁忌，经肝后下腔静脉前间隙入路行巨大肝癌切除安全可靠。Objective To investigate the possibility and the changing of the method of surgical excision for large hepatocellutar carcinoma （HCC）. Methods The clinical data of 38 cases with large HCC treated in our hospital from May 2003 to December 2006 were retrospectively analyzed. The av- erage diameter of the 38 cases was 14.4 cm （10.5-27 cm）. The hepatic artery and portal vein of the trouble side were ligated firstly in the operation and then the retrohepatic tunnel established. We took the method of the former approach to resect tumors retrogradely. Results The operation was success- fully conducted in all the 38 cases and the average amount of bleeding was 850ml （300-2700 ml）. No death occurred during hospitalization. The 1-, 2-and 3-year survival rates were 78. 9%, 57. 9% and 39.5%, respectively. Conclusion It is safe to resect the large HCC through the retrohepatic tunnel.

关 键 词：癌 肝细胞 肝切除 肝后下腔静脉前间隙 

分 类 号：R323.3[医药卫生—人体解剖和组织胚胎学] R735.7[医药卫生—基础医学]