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目的:探讨肝脏悬吊法进行第二肝门旁肝肿瘤肝切除的可行性与安全性。方法:回顾性分析2011年8月—2012年8月收治的7例第二肝门旁肝肿瘤病患者的临床资料。结果:7例术中顺利放置悬吊胶管并成功手术。行右半肝切除2例,右半肝+右肾周脂肪囊切除1例,右半肝切除+左肝内外叶2个血管瘤分别切除1例,右半肝+IV段部分切除术1例,左半肝+右肝VIII段+右膈肌浆膜切除1例,右肝VI,VII段规则切除术1例。术中无断肝时误伤下腔静脉者,行右膈肌浆膜修补1例。中位手术时间375 min(295~460 min),中位出血量2 000 mL(750~8 000 mL),中位输血量1 000 mL(0~4 000 mL)。术后胸腔积液2例,均经穿刺抽液恢复。无胆瘘,无腹腔感染。均痊愈出院,平均术后住院时间20 d。术后随访1~12个月,1例肝细胞癌有局部复发。结论:应用悬吊法进行第二肝门旁肝肿瘤肝切除是安全可行的。
Objective: To investigate the feasibility and safety of hepatic suspension for hepatectomy of the second hepatic hilus liver tumor. Methods: The clinical data of 7 patients with second hepatic hilar hepatoma who were admitted to our hospital from August 2011 to August 2012 were retrospectively analyzed. Results: 7 cases of surgical hysterectomy tubes were placed and successfully operated. Right hemihepatectomy in 2 cases, right hepatic + right renal capsule removal in 1 case, right hemihepatectomy + left hepatic and exocaval hemangiomas were removed in 1 case, right partial hepatectomy + IV partial resection in 1 case , Left hepatic + right hepatic segment VIII + right diaphragm resection in 1 case, right hepatic VI, VII segmental resection in 1 case. In the absence of intrahepatic cirrhosis of the inferior vena cava, the right diaphragm repair of serosa in 1 case. The median operative time was 375 min (range, 295-460 min), median blood loss was 2 000 mL (750-8 000 mL), and median transfusion volume was 1 000 mL (0-4 000 mL). Postoperative pleural effusion in 2 cases, both by puncture fluid recovery. No biliary fistula, no abdominal infection. All were cured and discharged, with an average postoperative hospital stay of 20 days. Follow-up 1 to 12 months after surgery, 1 case of local recurrence of hepatocellular carcinoma. Conclusion: It is safe and feasible to use suspension method to perform hepatectomy for the second hepatic hilar hepatic tumor.