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对肝上部(第七、八段)的肝切除术仍是难题,尤其对肝上部肿瘤复发因前次肝手术粘连使手术更为因难。日本九州大学医学系的外科医师们采用经膈(8例)和经腹(28例)为肿瘤位于第七或八段或肝静脉汇合处的肝细胞癌病人行肝切除术,两组病例肿块最大直径均小于3cm。经膈手术切口依B超探测进行定位,选择距离最近的肋间隙开胸,进胸对切断肋软骨而不切除肋骨,借助经膈B超确定膈肌切口位置,在不阻
Liver resection of the upper part of the liver (seventh and eighth paragraphs) is still a problem, especially for recurrence of upper liver tumors due to previous liver surgery. The surgeons of the Department of Medicine of Kyushu University in Japan used hepatectomy (8 cases) and transabdominal (28 cases) for hepatocellular carcinoma patients whose tumors were located in the seventh or eighth segment or hepatic vein junctions. The maximum diameter is less than 3cm. The orbital incision was positioned according to B-ultrasound detection. The nearest intercostal space was selected for thoracotomy. The thoracic cartilage was cut off without cutting off the ribs. The position of the diaphragmatic incision was determined by trans-sputum B ultrasound.