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目的探索巨大肝恶性肿瘤的可切除性和安全性的围手术期处理方法。方法 26例巨大肝恶性肿瘤,平均直径18.6cm,开腹后充分游离肝脏后暴露肿瘤,采用间歇性第一肝门阻断下进行肿瘤切除,切肝前根据需要预置肝下腔静脉阻断带以备用。结果 26例肿瘤均得以顺利切除,无其他严重并发症,仅1例术后死于上消化道出血。平均手术时间198min,肝门阻断时间平均39min,出血量平均1627ml。结论巨大肝恶性肿瘤切除难度大,但只要方法得当,围手术期处置适宜,仍是安全可行的方法。
Objective To explore the perioperative management of the resectable and safe mega hepatic malignancies. Methods 26 cases of massive hepatic malignancies with an average diameter of 18.6 cm were exposed after laparotomy. The tumors were exposed and the tumors were removed under intermittent first hepatic hilum obstruction. Before the liver was cut, the hepatic IVC block was preset as needed. Take spare. Results All the 26 tumors were successfully removed without any other serious complications. Only one patient died of upper gastrointestinal bleeding. The average operation time was 198 minutes, the duration of hepatic hilum obstruction was 39 minutes, and the average blood loss was 1627 ml. Conclusion It is difficult to remove huge hepatic malignancies. However, as long as the method is appropriate, it is still a safe and feasible method to deal with them properly during perioperative period.