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目的总结行解剖性肝切除的经验及结果。方法2004年1月至2005年6月期间,我们对93例肝细胞癌患者进行解剖性肝切除,对相应外科技术进行改进以减少术中出血、输血及术后并发症。切肝采用血管钳钳夹肝组织,暴露肝内管道后再结扎,选择性阻断出、入肝血流;对13例巨大肿瘤行半肝切除时采用肝脏悬吊法,切肝时采用间断Pringle法阻断肝门。结果93例肝癌患者中82例(88%)伴有不同程度的肝硬变,平均出血量300ml(100~6000ml),71%(66/93)病例不需输血。术后并发症发生率为34%(32/93),膈下积液多发,共8例。术后30d内无手术死亡。结论解剖性肝切除可能提高手术疗效。
Objective To summarize the experience and results of anatomic liver resection. Methods From January 2004 to June 2005, we performed anatomic hepatectomy on 93 patients with hepatocellular carcinoma. The corresponding surgical techniques were improved to reduce intraoperative bleeding, blood transfusion and postoperative complications. The hepatic duct was dissected with vascular forceps and the liver tissue was exposed after the hepatic duct was exposed. The hepatic blood flow was selectively blocked and the blood flow of the liver was observed. Thirteen cases of giant tumor were treated with liver suspension method, Pringle method to block the hilar. Results Of the 93 patients with hepatocellular carcinoma, 82 (88%) had cirrhosis of varying degrees, with an average blood loss of 300ml (100-6000ml) and 71% (66/93) of the patients without blood transfusion. The incidence of postoperative complications was 34% (32/93), multiple subdural effusion, a total of 8 cases. No operative death within 30 days after operation. Conclusions Anatomic liver resection may improve the curative effect.