绕肝提拉法前入路肝切除术(附6例临床报告)  

Anterior approach to hepatectomy by liver hanging maneuver:Report of 6 cases.

作　　者：彭淑牖[1] 李江涛[1] 曹利平[1] 刘颖斌[1] 王新保[1] 吴育连[1] 方河清[1] 王建伟[1] 许斌[1] 郑放[2] 

机构地区：[1]浙江大学医学院附属第二医院外科,杭州310009 [2]浙江大学医学院解剖教研室

出　　处：《中国实用外科杂志》2003年第10期598-600,共3页Chinese Journal of Practical Surgery

摘　　要：目的　绕肝提拉法 (liverhangingmaneuver)进一步提高前入路肝切除术 (anteriorapproach)的安全性。方法　钝性分离肝后下腔静脉前间隙而形成肝后隧道。通过该隧道安放绕肝带 ,前入路肝切除时拉紧绕肝带 ,配合自行设计的止血板 ,完成 6例复杂肝切除术。结果　 6例成功安放绕肝带 ,未发生与该操作有关的并发症 ,前入路肝切除时肝正中裂界面内管道显露清楚 ,绕肝带具有指示作用。结论　复杂肝切除时使用绕肝带和止血板 ,有助于提高前入路肝切除的安全性。保证断肝能在最短的界面上进行。Objective To enhance safety of anterior approach with improvements of liver hanging maneuver in difficult hepatectomy.Methods Retrohepatic tunnel was developed by dissecting the anterior surface of the retrohepatic portion of the IVC.Six difficult hepatectomies were performed with the use of liver hanging tape together with hemostatic plate in the process of anterior approach.Results Liver hanging tape was successfully placed in 6 cases without related complications.Under the guidance of liver hanging tape,vessels of parenchyma in middle plane were clearer in anterior approach hepatectomy.Conclusion With liver hanging tape combined with hemostatic plate,safety of anterior approach is enhanced in difficult hepatectomy.Liver transection can be performed in the shortest resection plane from the anterior surface of the liver to the anterior surface of IVC.

关 键 词：绕肝提拉法 前入路 肝切除术 安全性 肝癌 

分 类 号：R735.7[医药卫生—肿瘤] R730.56[医药卫生—临床医学]