CAJ | 학술논문

目的介绍我们使用双绕肝提拉法施实规则性右半肝切除术的经验.方法 24例病人施行了双绕肝提拉前入路法右半肝切除,以49例采用传统方法行右半肝切除的病人作为对照组,分析了双绕肝提拉法的优势.结果 27例病人成功建立肝后下腔静脉隧道,其中24例病人通过双绕肝提拉法行规则右半肝切除,3例病人因肿瘤接近正中裂而放弃双绕肝法.与对照组比较,使用双绕肝提拉法的病人术中出血量少(t=3.191,P＜0.05),术后ALT恢复快(t=2.398,P＜0.05)、肝功能Child分级好(χ2=9.31,P＜0.05).两组病人手术时间无明显差异(t=-1.695,P＞0.05).绕肝带提拉肝脏后,由于肝后下腔静脉与肝脏之间产生1～2 cm的间隙,故切肝时无一例损伤肝后下腔静脉及肝静脉.结论双绕肝提拉前入路法能提高规则右半肝切除的安全性及成功率.
목적 개소아문사용쌍요간제랍법시실규칙성우반간절제술적경험.방법 24례병인시행료쌍요간제랍전입로법우반간절제,이49례채용전통방법행우반간절제적병인작위대조조,분석료쌍요간제랍법적우세.결과 27례병인성공건립간후하강정맥수도,기중24례병인통과쌍요간제랍법행규칙우반간절제,3례병인인종류접근정중렬이방기쌍요간법.여대조조비교,사용쌍요간제랍법적병인술중출혈량소(t=3.191,P＜0.05),술후ALT회복쾌(t=2.398,P＜0.05)、간공능Child분급호(χ2=9.31,P＜0.05).량조병인수술시간무명현차이(t=-1.695,P＞0.05).요간대제랍간장후,유우간후하강정맥여간장지간산생1～2 cm적간극,고절간시무일례손상간후하강정맥급간정맥.결론 쌍요간제랍전입로법능제고규칙우반간절제적안전성급성공솔.
Objective To introduce the application of double liver hanging maneuver in anatomical right hemihepatectomy and share our own experience. Methods Twenty-four patients underwent right hemihepatectomy using double liver hanging maneuver, and the data were collected prospectively after operation. Another 49 patients underwent right hemihepatectomy using the traditional methods,serving as the control group. Results Retrohepatic tunnel was constructed in 27 patients, double liver hanging maneuver was successfully performed in 24 anatomical right hemihepatomy and failed in 3 patients due to the near proximity between the tumor and the middle line. Compared with the control group, blood loss was much less (t=3. 191 ,P＜0.05), ALT and liver function recovered more quickly postoperatively and the difference in operative duration between the 2 groups was not significant (t=-1. 695,P＞0. 05). There was about 1-2 cm wide space located between retrohepatic IVC and dorsal liver when the 2 tapes were tracted, and no injury in hepatic short veins and retrohepatic IVC occurred during the operation. Conclusion The double liver hanging maneuver can make anatomical right hemihepatectomy more accessible and safe.