CAJ | 학술논문

目的研究联合尾状叶切除的半肝切除术的合理性和可行性,并探讨其适应证.方法回顾性分析31例联合部分或全部尾状叶切除的半肝切除术病例,其中原发性肝癌16例、肝转移癌1例、肝门部胆管癌5例、肝内胆管结石4例、肝巨大血管瘤3例、肝炎性假瘤1例、肝外伤1例.结果手术完成时间130~367 min,平均(218±61) min.术中出血80~1 100 ml,平均(350±283)ml,19例患者术中未输血.无围手术期死亡.术后并发症总发生率为35.5%(11/31).其中,右侧胸腔积液5例;切口脂肪液化2例;轻度肝性脑病1例;胆漏3例,均经保守治疗而痊愈.结论肝脏的良性或恶性病变侵及尾状叶时,实施联合尾状叶的半肝切除术是安全可行的.
목적 연구연합미상협절제적반간절제술적합이성화가행성,병탐토기괄응증.방법 회고성분석31례연합부분혹전부미상협절제적반간절제술병례,기중원발성간암16례、간전이암1례、간문부담관암5례、간내담관결석4례、간거대혈관류3례、간염성가류1례、간외상1례.결과 수술완성시간130~367 min,평균(218±61) min.술중출혈80~1 100 ml,평균(350±283)ml,19례환자술중미수혈.무위수술기사망.술후병발증총발생솔위35.5%(11/31).기중,우측흉강적액5례;절구지방액화2례;경도간성뇌병1례;담루3례,균경보수치료이전유.결론 간장적량성혹악성병변침급미상협시,실시연합미상협적반간절제술시안전가행적.
Objective To explore the rationality and possibility of right or left hemihepatectomy combined with partial or whole caudate lobectomy and analyze its indications. Methods Thirty-one patients surgically treated by hemihepatectomy combined with caudate lobectomy were retrospectively studied. The primary lesions included hepatocellular carcinoma (n=16),hilar cholangiocarcinoma (n=5),giant hemangioma (n=3),hepatolithiasis (n=4),hepatic metastasis (n=1),liver injury (n=1),hepatic inflammatory pseudotumor (n=2). Sixteen of the total were operated with right hemihepatectomy combined with caudate lobectomy and fifteen of them with left hemihepatectomy combined with caudate lobectomy. Result The average operating time was(218 ± 61)min(130~367 min). The average amount of blood loss was(350±283)ml(80~1 100 ml). Nineteen of the total were not given transfusion because their blood loss were less than 300ml during operation. The perioperative mortality was 0 and total morbidity was 35.5%(11/31),including pleural effusion (n=5),fat liquefaction of incision (n=2),slight hepatic encephalopathy (n=1),biliary leakage(n=3). All complications were treated successfully without operation. Conclusion Liver lesions involving caudate lobe,either benign or malignant,hemihepatectomy combined with partial or whole caudate lobectomy could be safe and effective.