肝尾叶切除治疗尾叶肝癌:附11例报告
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温增庆

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Caudate lobectomy for liver cancer in candafe lobe:a report of 11 cases
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    摘要:

    目的:探讨肝尾叶切除治疗尾叶肝癌的安全方法。
    方法:回顾分析11例肝癌行尾叶成功切除的临床资料,并提出肝脏尾叶切除的4个安全方法:(1)选择合适的手术切口,使手术野有良好暴露;(2)充分游离肝脏,使肝脏可向上、左或右侧翻动;(3)备全肝血流阻断带,根据需要,以备随时阻断全肝血流;(4)根据肿瘤情况决定理想的切肝手术入路;必要时采取多叶联合切除。11例中单纯阻断第一肝门切除尾叶6例,其余病例在多次阻断或全肝血流阻断下切除尾叶。联合右肝部分切除2例,联合左外叶切除3例,尾叶单独切除6例。
    结果:11例患者均顺利完成手术,无手术死亡。
    结论:采用上述措施,可安全行肝尾叶肝癌切除。

    Abstract:

    Abstract:Objective:To explore the safe technique of caudate lobectomy for liver cancer in candafe lobe(LCCL).
    Methods :The clinical data of 11 cases of primary liver cancer in caudate lobe who received hepatectomy successfully were retrospectively analyzed. four procedures were used in the operations:(1)selection of appropriate skin incision, so as to obtain excellent exposure of operative field;(2)adequate mobilization of the liver to allow the liver to be displaced upwards to the left or to the right;(3)preparatory placement of tapes for total hepatic vascular isolation,so that this procedure can be used when necessary;(4)selection of the ideal route for hepatectomy based on the condition of the tumor and, if necessary, the combined removal of multiple lobes. Among the 11 cases, simple occlusion of vessels of porta hepatis was used for candate lobectomy in 6 cases, while, in the other cases, the vessels were intermittently occluded several times or total hepatic vlascular isolation was used for the caudate lobectomy. combined partial right hepatectomy was done in 2 cases, combined left lateral lobectomy in 3 cases and caudate lobectomy alone in 6 cases.
    Results:Operation was smooth and successful in all of the 11 cases, and there was no mortality.
    Conclusions:Caudate lobectomy for LCCL can be safely performed when the above procedures are used.

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温增庆,严以群,杨甲梅,吴孟超.肝尾叶切除治疗尾叶肝癌:附11例报告[J].中国普通外科杂志,2007,16(3):1-.
DOI:10.7659/j. issn.1005-6947.2007.03.001

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  • 在线发布日期: 2007-03-25