CAJ | 학술논문

目的探讨紧邻肝门及重要血管的肝血管瘤的手术方式及其安全性.方法总结自2005年6月至2010年6月解放军第一零一医院对17例患者紧邻肝门及肝内外重要血管的肝血管瘤施行肝切除手术的方法和效果.结果本组17例患者均手术成功,无手术死亡.规则性肝叶切除术6例,其中绕肝提拉法前入路右半肝切除术2例,肝右后叶切除术2例,左半肝切除术2例;外膜剥离术8例;肝实质劈开加外包膜剥离术3例.在绕肝提拉法前入路右半肝切除术患者中,采用选择性连续右半肝血流阻断法,其他患者采用常温下间歇性入肝血流阻断法.术后并发症:胸腔积液5例,伤口感染1例,肺部感染1例.本组患者均痊愈出院.结论根据患者肝血管瘤的不同部位、大小以及与肝门、肝内、外重要血管的关系,采用不同的手术切除方式,有助于提高手术安全性.
목적 탐토긴린간문급중요혈관적간혈관류적수술방식급기안전성.방법 총결자2005년6월지2010년6월해방군제일령일의원대17례환자긴린간문급간내외중요혈관적간혈관류시행간절제수술적방법화효과.결과 본조17례환자균수술성공,무수술사망.규칙성간협절제술6례,기중요간제랍법전입로우반간절제술2례,간우후협절제술2례,좌반간절제술2례;외막박리술8례;간실질벽개가외포막박리술3례.재요간제랍법전입로우반간절제술환자중,채용선택성련속우반간혈류조단법,기타환자채용상온하간헐성입간혈류조단법.술후병발증:흉강적액5례,상구감염1례,폐부감염1례.본조환자균전유출원.결론 근거환자간혈관류적불동부위、대소이급여간문、간내、외중요혈관적관계,채용불동적수술절제방식,유조우제고수술안전성.
Objective To explore the surgical modality and safety of hepatectomy for hepatic hemangiomas close adjoining the hepatic portal and vital blood vessels. Methods From June 2005 to June 2010 17patients of hepatic hemangiomas underwent hepatectomy. Data were retrospectively analyzed.Results All the 17 cases were operated on successfully. Six cases were treated with anatomic liver lobectomy including right hemibepatectomy through liver hanging maneuver by anterior approach in 2 cases,under right liver blood vessel blochade and anatomic right posterior hepatectomy in 2 cases, left hemihepatectomy in 2 cases. Eight cases were treated by hemangiomas enucleation, in 3 cases hemangioma was enuleated through liver parenchyma splitting under intermittent hepatic blood inflow exclusion. There was no postoperative mortality, postoperatively pleural effussion occured in 5 cases,wound infection occured in 1 case, and pulmonary infection occured in 1 case, all the cases were cured. Conclusions Different operation styles should be applied according to the position, size of hepatic hemangiomas close adjoining the hepatic portal and the important blood vessels.