CAJ | 학술논문

Belghiti 等于2001年首次提出肝脏悬吊法经前入路行右半肝切除术，但由于其在肝后下腔静脉前方盲目建立隧道过程中，易撕裂肝短静脉和肝实质引起出血，难以推广。此后陈孝平等建立一种新的肝脏悬吊技术，即沿腔静脉右侧肝后间隙经肝裸区做隧道置悬吊技术。该方法简单、安全，能充分显露深部肝断面，便于止血，尤其是可有效控制来自肝静脉分支的出血。本文介绍我们应用经裸区肝脏悬吊法行右肝巨大肿瘤右半肝切除的经验，并就其相关的解剖学要点，操作要领以及术中应注意的问题进行讨论。
Belghiti 등우2001년수차제출간장현조법경전입로행우반간절제술，단유우기재간후하강정맥전방맹목건립수도과정중，역시렬간단정맥화간실질인기출혈，난이추엄。차후진효평등건립일충신적간장현조기술，즉연강정맥우측간후간극경간라구주수도치현조기술。해방법간단、안전，능충분현로심부간단면，편우지혈，우기시가유효공제래자간정맥분지적출혈。본문개소아문응용경라구간장현조법행우간거대종류우반간절제적경험，병취기상관적해부학요점，조작요령이급술중응주의적문제진행토론。
As a safer approach to right hemi-hepatectomy exposure of deeper parenchymal tis-sue during liver transaction,a liver-hanging maneuver(LHM)of tightening for huge liver tumor was proposed by Belghiti et al in 2001 .However,this procedure is performed blindly,there are potential risks of damaging small retrohepatic veins and consequential bleeding.To overcome this dilemma, Chen XP et al modified the procedure as transbare-area liver hanging maneuver (TBLHM).Retrohe-patic space tunneling was developed to the right of IVC.Then a tape could be passed around liver pa-renchyma to elevate liver away from IVC.And upward traction of tape allow better hemostasis of transection surface,especially for bleeding from branches of hepatic veins.Our experiences of right hemi-hepatectomy for huge liver tumor via TBLHM were summarized.In addition,anatomical es-sentials and major technical aspects of mobilization of right hepatic lobe were included.