摘要
目的研究联合尾状叶切除的半肝切除术的合理性和可行性,并探讨其适应证。方法回顾性分析31例联合部分或全部尾状叶切除的半肝切除术病例,其中原发性肝癌16例、肝转移癌1例、肝门部胆管癌5例、肝内胆管结石4例、肝巨大血管瘤3例、肝炎性假瘤1例、肝外伤1例。结果手术完成时间130-367 min,平均（218±61）min。术中出血80-1 100 ml,平均（350±283）ml,19例患者术中未输血。无围手术期死亡。术后并发症总发生率为35.5%（11/31）。其中,右侧胸腔积液5例;切口脂肪液化2例;轻度肝性脑病1例;胆漏3例,均经保守治疗而痊愈。结论肝脏的良性或恶性病变侵及尾状叶时,实施联合尾状叶的半肝切除术是安全可行的。
Objective To explore the rationality and possibility of right or left hemihepatectomy combined with partial or whole caudate lobectomy and analyze its indications. Methods Thirty- one patients surgically treated by hemihepatectomy combined with caudate lobectomy were retrospectively studied. The primary lesions included hepatocellular carcinoma（n=16）,hilar cholangiocarcinoma（n=5）,giant hemangioma（n=3）,hepatolithiasis（n=4）,hepatic metastasis（n=1）,liver injury（n=1）,hepatic inflammatory pseudotumor（n=2）. Sixteen of the total were operated with right hemihepatectomy combined with caudate lobectomy and fifteen of them with left hemihepatectomy combined with caudate lobectomy. Result The average operating time was（218 ± 61）min（130~367 min）. The average amount of blood loss was（350±283）ml（80~1 100 ml）. Nineteen of the total were not given transfusion because their blood loss were less than 300 ml during operation. The perioperative mortality was 0 and total morbidity was 35.5%（11/31）,including pleural effusion（n=5）,fat liquefaction of incision（n=2）,slight hepatic encephalopathy（n=1）,biliary leakage（n=3）. All complications were treated successfully without operation. Conclusion Liver lesions involving caudate lobe,either benign or malignant,hemihepatectomy combined with partial or whole caudate lobectomy could be safe and effective.
出处
《外科研究与新技术》
2015年第2期81-84,共4页
Surgical Research and New Technique
基金
山东省卫生系统1020工程人才基金资助
山东省自然科学基金资助(Y2004Z12)
