摘要
目的:评估高选择性区域血流阻断技术在复杂性肝癌切除中的意义。方法:在68例复杂性肝癌切除中,先结扎、切断第三肝门所有的肝短血管,再分别在第一、二肝门处游离出患侧肝蒂及主肝静脉并阻断。观察术中出血量、术后肝功能的变化及术后并发症。结果:68例中65例在肝外游离出主肝静脉并加以阻断,3例以小的心耳钳沿腔静脉方向纵行夹住主肝静脉阻断出肝血流,并常规行患侧肝蒂间歇性阻断。术中出血400～1200(600±200)mL,有26例(65%)没有输血。术后无1例发生肝功能衰竭。术后膈下感染2例,胆漏2例,经引流自愈。结论:在复杂性肝癌切除中,肝脏高选择性区域血流阻断技术可有效减少术中出血,降低术后肝功能衰竭发生率。
Objective To evaluate the highly-selective regional vascular exclusion in the risk hepatectomy for liver tumor.Methods Short hepatic veins were ligated and divided followed by the dissection,and isolation of the inflow and outflow vessels of the tumor-bearing lobe,which were completely devascularized after the occlusion of these vessels.The blood loss volume,postoperative recovering situation of the liver function and the incidence of complication were observed in 68 cases.Results Main hepatic veins were dissected and isolated exo-hepatically in 65 cases.In the other 3 cases,the main hepatic veins were blocked by Satinskin clamp applied longitudely along the inferior vena cava.Hepatic pedicle was routinely excluded.The amount of blood loss was from 400 to 1 200（600±200）mL and 26（65%）cases didn＇t receive transfusion.There was no operative mortality and liver function failure.Surgical complications included subphrenic abscess in 2 cases and bile leakage in 2 cases,which were cured conservatively.Conclusion Highly-selective regional exclusion of hepatic blood flow during the risk hepatectomy is safe and effective to prevent massive bleeding and to reduce the incidence of liver failure.
出处
《中南大学学报（医学版）》
CAS
CSCD
北大核心
2007年第6期1085-1088,共4页
Journal of Central South University ：Medical Science
关键词
主肝静脉
肝蒂
肝切除
肝血流阻断
main hepatic vein
hepatic pedicle
hepatectomy
highly-selective regional vascular exclusion
