摘要
通过13头家猪的实验研究建立了离体肝脏切除及自体残肝再植术的技术方法，并发现离体肝切除术所致肝脏损害主要发生在残肝植入后的再灌流时相，而残肝能量状态的恢复与手术预后有关。在动物实验研究的基础上，采用全肝血液转流及冷灌注下的半离体肝切除术成功地切除了1例侵犯主干静脉及肝后段腔静脉并伴有早期肝硬变的肝门区巨大肝癌。实验研究结果及初步临床经验表明，全肝血液转流及冷灌注下的离体肝切除术是切除常规手术方法难以切除的肝门区巨大肿瘤的有效途径；虽然此手术对肝脏有一定的侵袭性，但仍可用于伴有肝硬变而肝脏储备功能良好的肝癌病人。
In present study the techniques of extracorporeal hepatic resection were estabolished with porcine experiments, in which the whole liver was skeletonized and removed to back table to be partially resected and the helatic autograft was transplanted in an orthotopic position on total hepatic blood bypass and hypothermic liver perfusion. The abnormalenergy status in the liver of the animals during the surgery was revealed to correlate with theoperative outcome. Based on the experience with the experimants, we successfully performedex-situ in-vivo hepatic resection under total hepatic blood bypass and hypothermic liverperfusion in one cirrhotic patient who was judged to have inoperable tumor invading the confluence of the hepatic veins and inferior vena cava by conventional means.
出处
《肝胆外科杂志》
1997年第4期209-213,共5页
Journal of Hepatobiliary Surgery
关键词
体外实验
肝切除
全肝血液转流
血液转流
Extracorporeal liver surgery Hypothermic perfusion Hepatic resection
