摘要
目的探讨肝中叶切除术在中央型肝癌外科治疗中的合理性和安全性。方法从2006年6月-2009年6月,该组共对21例中央型肝癌采用肝中叶切除。肿瘤直径6~15cm,平均11.5cm,其中超过10cm者13例;合并门静脉癌栓（PVTT）7例;下腔静脉癌栓1例。术前肝功能Child–Pugh A级18例,B级3例。术中同时行门静脉/下腔静脉取栓和胆道减压术。结果肝血流累计阻断时间13-45min,平均21min。术中出血450-3200mL不等,平均850mL。手术均获成功。除1例患者术后10d死于大面积脑梗死外,其余均痊愈出院。随访生存超过6个月19例（90.5%）,超过12个月14例（66.7%）,24个月9例（42.9%）。结论掌握手术技巧并作好围手术期处理,肝中叶切除术是中央型肝癌治疗最有效的方法。
【Objective】 To explore the rationality and safty of mesohepatectomy for treatment of centrally located hepatic tumor.【Methods】 The data of 21 patients underwent mesohepatectomy in our department from June 2006 to June 2009 was analysed retrospectively.The diameters of tumor measured 11.5 cm in average（6-15 cm）,13 cases were larger than 10 cm.Tumor combined with port vein tumor thrombus in 7 patients and 1 case with intra venous cava thrombus.The preoperative liver function was graded as A in 18 patients and B in 3 ones.Extraction underwent in all patients with thrombi,Prophylactic exploration of the common bile duct was in all patients.【Results】 The occlusion time ranged from 13 to 45 minutes,21 minutes in average.The mean intraopertive blood loss was 850 ml（450-3200ml）.The duration of operation in all cases was successfully.All patients were discharged from hospital except 1 cases died of cerebral infarction 10 days postoperatively.All patients were followed-up,19 patients have survived over 6 months,14 cases over 12 months and 9 cases over 24 months.【Conclusion】 With operative skill and proper perioperative treatment,mesohepatectomy is an effective method for tumor centrally located in liver.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2011年第7期878-880,共3页
China Journal of Modern Medicine
