肝癌伴门静脉高压症的外科处理28例报告  

Surgical management of liver carcinoma accompanied by portal hypertension

作　　者：杨威[1] 王国俊[1] 丁思勤[1] 刘青光[1] 潘承恩[1] 

机构地区：[1]西安交通大学第一医院肝胆外科,710061

出　　处：《中华普通外科杂志》2002年第4期200-201,共2页Chinese Journal of General Surgery

摘　　要：目的评价不同手术方法治疗肝癌合并门静脉高压症的效果。方法回顾性分析1992年 1月至 2 0 0 0年 6月肝癌和门静脉高压症同期手术治疗 2 8例。结果全组无手术死亡。术后并发症发生率为 39% (11/ 2 8)。术后 1、3、5年生存率为 91%、6 1%、48%。术后上消化道出血 9例 ,随访中死亡 13例 ,死亡原因 :肝癌复发 6例 ,肝功能衰竭 2例 ,上消化道出血 5例 ,其中 1例于术后 1个月内死亡。结论合理选择术式可延长生存期 ,减少术后并发症。贲门周围血管离断术对防止术后再出血效果较好。肝癌体积较大时 ,宜简化手术操作。ObjectiveTo evaluate the effects of various surgical procedures on liver carcinoma accompanied by portal hypertension. MethodsOne stage surgical procedure was performed in 28 cases of liver carcinoma accompanied by portal hypertension in our department from January 1992 to June 2000. ResultsThere was no operative mortality. The postoperative complications developed in 39%(11/28). The postoperative survival rates of 1?2 and 3 years were respectively 91%, 61%, and 48%. Postoperative upper digestive tract hemorrhage developed in 9 cases, 13 cases died during follow-up period, of whom 6 cases died of the recurrence of liver carcinoma, 2 cases died of liver failure, 5 cases died of upper digestive tract hemorrhage.Conclusions The survival time can be prolonged and the postoperative complications reduced through prudent selection of surgical procedures in patients suffering from concurrent liver cancer and portal hypertension. Postoperative recurrent bleeding can be prevented by pericardial devascularization. In poor risk cases with huge carcinoma, simple surgical procedure should be applied,and with a discreet application of chemoembolization.

关 键 词：肝癌 门静脉高压症 肝硬化 并发症 手术治疗 

分 类 号：R657.3[医药卫生—外科学]