摘要
目的 评估肝静脉主干和 (或 )下腔静脉血流控制在高难度肝切除术中的作用和意义。方法 对 33例位于Ⅳ、Ⅶ、Ⅷ段和左半肝、右半肝、右三叶的肝肿瘤进行了游离下腔静脉和肝静脉主干并加以控制的肝切除术。其中肝细胞性肝癌 2 6例 ;胆管细胞性肝癌 2例 ;转移性肝癌 2例 ;肝血管瘤 3例。 32例患者在术中成功预置了下腔静脉和肝静脉的阻断带 ,必要时控制肝静脉和下腔静脉血流。 1例患者预置肝静脉阻断带失败。结果 33例全部成功切除肿瘤 ,术中输血 0～ 16 0 0ml,其中 7例没有输血。全组无术中死亡病例。结论 熟练掌握和合理控制肝静脉主干和下腔静脉血流 ,可以提高复杂肝肿瘤切除的安全性和减少输血 ,有助于完成高难度肝肿瘤的切除。
Objective To explore the role of extrahepatic control on blood flow of hepatic vein and inferior vena cava in hepatectomy,and observe its effect on minimizing hemorrhage.Methods From 2001 to April 2003,33 patients who had liver tumors involving segment Ⅳ,Ⅶ,Ⅷ or half liver underwent major hepatectomies that required exposure of the inferior vena cava and main trunks of hepatic veins,during which the major hepatic veins and inferior vena cava were isolated and taped to control blood flow when necessary. Results In 33 attemps,32 were successful and all tumors were resected successfully . The placement of occlusion tape was unsuccessful in 1 case. 7 cases did not need blood transfusion during operation. The amount of blood transfusion for other cases were form 0 to 1 600 ml. there was no operative mortality.Conclusions Appropriate control of main truck of hepatic vein and inferior vena cava is effective in reducing blood loss during hepatectomies. It is also very helpful for performing diffcult hepatectomies.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2004年第5期260-264,共5页
Chinese Journal of Surgery
