肝圆韧带间置肠肝吻合术在肝门区肿瘤外科治疗中的应用价值  

Application value of using enterohepatic anastomosis with interposition of round ligament in surgical treatment of tumors in hepatic hilar region

作　　者：吴松 刘振忠 李筱倩 WU Song;LIU Zhenzhong;LI Xiaoqian(Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong 271000, China)

机构地区：[1]山东第一医科大学第二附属医院肝胆外科

出　　处：《中国普通外科杂志》2019年第7期833-839,共7页China Journal of General Surgery

摘　　要：目的:探讨肝门区肿瘤外科治疗中采用肝圆韧带间置肠肝吻合术的临床应用效果。方法:选取山东第一医科大学第二附属医院肝胆外科收治的97例肝门区肿瘤患者,采用随机数字表法分为研究组(49例)和对照组(48例),两组患者均行肝门区肿瘤切除术,术中研究组采用肝圆韧带间置肠肝吻合术,对照组采用常规吻合术。比较两组相关手术指标、肝功能指标及生存率差异。结果:两组术前一般资料差异无统计学意义(均P>0.05)。两组手术时间、术中出血量、住院时间比较差异无统计学意义(均P>0.05);两组术后48 h主要肝功能指标、血红蛋白及白细胞水平均较术前明显升高(均P<0.05),但两组间差异均无统计学意义(均P>0.05);研究组患者的并发症发生率明显低于对照组(26.53%vs. 54.17%,P<0.05);两组术后1、2、3年的生存率差异均无统计学意义(均P>0.05)。结论:肝门区肿瘤手术治疗中采用肝圆韧带间置肠肝吻合术能够获得与常规吻合术相当的近远期疗效,并可显著减少手术并发症的发生,推荐临床使用。Objective: To investigate the clinical effect of using interposition of the hepatic round ligament in surgical treatment of tumor in the hepatic hilar region. Methods: Ninety-seven patients with tumor in the hepatic hilar region admitted in Department of Hepatobiliary Surgery of the Second Affiliated Hospital of Shandong First Medical University were enrolled, and were randomly assigned into the study group(49 cases) and the control group(48 cases) by using random number table. Both groups of patients underwent hilar tumor resection, and patients in study group underwent enterohepatic anastomosis with interposition of the hepatic round ligament, while those in control group underwent conventional anastomosis during operation. The main surgical variables, liver function parameters and survival rates were compared between the two groups of patients.Results: The preoperative data showed no significant differences between the two groups(all P>0.05). No statistical differences were noted in operative time, intraoperative blood loss, and length of hospitalization between groups(all P>0.05). The main parameters of liver function, the hemoglobin levels and the white blood cell counts were all significantly increased in both groups on 48 h after operation compared with their preoperative values(all P<0.05), but all showed no significant differences between the two groups(all P>0.05). The overall incidence of postoperative complications was significantly lower in study group than that in control group(26.53% vs. 54.17%, P<0.05). There were no significant differences in 1-, 2-and 3-year survival rates between the two groups(all P>0.05).Conclusion: In surgical treatment of tumor in the hepatic hilar region, enterohepatic anastomosis with interposition of the hepatic round ligament can achieve the similar short-and long-term efficacy as the conventional enterohepatic anastomosis, with reduced complications. So, it is recommended to be used in clinical practice.

关 键 词：肝肿瘤 肝切除术 胆管肠吻合术 肝 

分 类 号：R735.7[医药卫生—肿瘤]