前入路绕肝提拉法在复杂右半肝切除中的应用体会  

Around the anterior liver czochralski method right hepatectomy in a complex application experience

作　　者：陈虎[1] 张恺欣[1] 王瑞[1] 赵以模[1] 

机构地区：[1]泗洪县人民医院普外科,江苏泗洪223900

出　　处：《医学信息（内.外科版）》2009年第8期711-712,共2页Medical Information Operations Sciences Fascicule

摘　　要：目的在复杂右半肝切除中应用肝后下腔静脉前间隙建立隧道,放置弹性绕肝带,悬吊提拉肝脏后行前入路右半肝切除,分析前入路绕肝提拉法在12例复杂右半肝切除中的应用结果,探讨前入路绕肝提拉法在复杂右半肝切除中的作用以及对肝后下腔静脉的保护,对切肝方向的指引和无瘤操作的作用。方法对12例行右半肝切除的患者手术应用前入路绕肝提拉法,先不游离肝周韧带,钝性分离肝后下腔静脉前间隙,建立隧道,放置提拉带,悬吊提拉后采用前入路切除右半肝。结果12例患者均成功建立肝后隧道放置绕肝提拉带,未出现因此操作所引起的严重并发症。均成功切除。结论在复杂右半肝切除中应用前入路绕肝提拉法,不必搬动右肝,使手术困难或无法切除的病例变的容易或可以切除,此外,使肝后下腔静脉以及肝脏各种管道得到更有效安全的保护,切肝的方向得到指引,提高了半肝切除的安全性。Objective Right hepatectomy in a complex application of the inferior vena cava after liver gap before the establishment of the tunnel, placing elastic band around the liver, the liver suspension later pulling into the road right before the liver resection, analysis of the liver around the anterior tirat complex in 12 cases of right hepatectomy in the application of the results to explore around the liver anterior Czochralski method in a complex right in the role of hepatectomy and inferior vena cava after liver protection and liver of all the guidance and direction The role of tumor op- eration. Methods Twelve routine right hepatectomy in patients with the application of the anterior liver around the Czochralski method, the first week of non - free liver ligaments, blunt separation of the inferior vena cava after liver pre - clearance, the establishment of tunnels, placed to La zone, Czochralski suspended after anterior resection using right liver. Results Twelve patients were successfully placed the tunnel after the establishment of the liver around the he- patic tirat belt, so the operation does not appear serious complications arising. Were successfully removed. Conclu- sions The complexity of the application of right hepatectomy anterior Czochralski method around the liver, do not have to move right hepatic make surgery difficult or unresectable cases can be changed or removed easily, in addition to the liver after vena cava and the liver of various pipeline safety has been more effective protection, the direction of hepatic guidance to improve the semi - safety of liver resection.

关 键 词：前入路肝切除术 肝肿瘤 肝后隧道 绕肝提拉 

分 类 号：R657.3[医药卫生—外科学]