摘要
肝脏海绵状血管瘤的最好治疗方法是手术切除，但对已侵犯肝门的血管瘤手术风险较大，肛门的处理是手术的最大难题。我科自94年2月至97年2月共收治21例紧贴一、二、三肝门的巨大血管瘤，瘤体最大径线12～36cm，平均24cm。术中先结扎患侧肝动脉，然后再解剖分离肝门，在第一肝门阻断下全部完整切除了瘤体，行肝右三叶及尾状叶切除5例，右半肝及尾状叶切除7例，右半肝切除1例，右肝上段切除3例。右后叶切除2例，左三叶及尾状叶切除3例。术后无并发症，全部恢复良好。本文着重讨论了瘤体切除时肝门的操作步骤及其注意点，特别在此手术成功的关键，肝短静脉及肝静脉的操作方面进行了讨论。全部病例皆未行全肝血流阻断，较好地避免了可能由于阻断带来的并发症。
Surgical excision is the best treating method for carvernous hemangioma of theliver. The operation is difficult for the hemangioma which involves the porta hepatis. So themanagement of porta hepatis is the key problem during the operation. 21 cases with largecarvernous hemangioma of the liver which involved the first,second and third prota hepatiswere admitted from February 1994 to February 1997. The largest diameter was 12cm to 36cmin size with mean 24cm in diameter. The hepatic artery on the diseased side was ligated firstfollowed by dissecting the porta hepatis, at last, tumor was resected under intermittent interruption of porta hepatic blood flow. Among the 21 cases, right trilobectomy and caudatelobectomy in 5, right trilobectomy in 1, right superior lobectomy in 3, right posterior lobectomy in 2,left trilobectomy and caudate lobectomy in 3. The comlication did not occur following the operation and the patients are living and well. The dissection method of portahepatis and the point of attention during the operation was discribed, the management ofshort hepatic vein and hepatic vein was discussed in some detail. The bloodless hepatic resection was not adopted in all of the patients, and the complication of which was avoided.
出处
《肝胆外科杂志》
1997年第4期214-217,共4页
Journal of Hepatobiliary Surgery
