选择性肿瘤侧肝血管完全阻断法的肝切除术  

The hepatecomy by selectively interputting liver blood vessels of tumor affected side

作　　者：李爱辉[1] 覃谦[1] 王力斌[1] 李洪[1] 欧阳杰[1] 梁卓虹[1] 谢书勤[1] 

机构地区：[1]中山大学附属东华医院肿瘤外科,广东东莞523110

出　　处：《中国肿瘤外科杂志》2010年第3期137-139,159,共4页Chinese Journal of Surgical Oncology

摘　　要：目的对预先将肿瘤侧肝血管进行阻断或结扎的肝切除术方法进行探讨。方法 2007年3月至2009年12月,对26例肝肿瘤患者采取预先将肿瘤侧的肝动脉、门静脉和肝静脉阻断或结扎以及建立肝后下腔静脉隧道置阻断带联合阻断下完成复杂性肝切除术。结果全组26例患者在分离肝外血管过程中顺利,在切肝过程中出血量最少为100 mL,最多为1 200 mL,平均出血量380 mL。术后并发胸腔积液6例,其中2例为中等量积液通过胸穿抽液后治愈,另4例因积液量少而自行吸收。无围手术期死亡,无胆瘘、腹腔感染及其他并发症发生。结论预先进行肿瘤侧肝动脉、门静脉、肝静脉阻断或结扎以及利用肝后隧道放置阻断带联合阻断下进行复杂性肝切除术可以减少术中出血,对保留肝侧组织防止再灌注损伤和并发肝功能损害等具有重要意义。Objective To explore the method of pre-interruption for liver blood vessels of tumor affected side in hepatectomy. Methods 26 cases of liver tumor were under complicated hepatectomy by blocking or li- gating hepatic artery., portal vein and hepatic vein and setting up a tunnel at the posthepatic inferior vena cava from March, 2007 to Deecember, 2009. Results Extrahepatie blood vessels were dissociated successfully in all 26 cases. The blood loss was from 100 ml to 1200 ml, and 380 ml in average during the hepatectomy. 6 cases were complicated of pleural effusion. 2 cases with moderate quantity of effusion were cured by thoraeentesis. 4 cases with little pleural effusion was absorbed by themselves. There were no death, biliary fistula, celiac infec- tion and other complications. Conclusions This complicated hepatectomy can reduce the bleeding and the damage to hepatic functions, and keep from injury of remnant liver repeffusion.

关 键 词：肝肿瘤 肝血管阻断 肝切除术 

分 类 号：R735.7[医药卫生—肿瘤]