Tekin A, Perek S
Department of Surgery, Mersin State Hospital, Mersin, Turkey.
Dig Surg. 2000;17(4):395-8. doi: 10.1159/000018884.
After partial hepatectomy, liver regeneration occurs with the hepatocyte mass to its almost previous size. Biliary stricture due to hypertrophied liver rotation following partial hepatectomy is uncommon and its management still remains controversial. We encountered extrahepatic biliary stricture due to hypertrophied left lobe rotation in 2 patients who had right hepatic lobectomy for liver trauma. Herein, we present our experience with the modified Longmire procedure for the management of this complication.
There were no complications during the early postoperative period in either of the patients. After the Longmire procedure, the first patient was followed for 5 months with some elevation in liver enzymes and the other was followed for 14 months with normal liver function tests. Both of the patients are completely symptom free postoperatively.
The present experience suggests that the modified Longmire procedure is the most promising surgical approach to the management of biliary stricture due to hypertrophied left lobe rotation after right hepatic lobectomy.
部分肝切除术后，肝脏会再生，肝细胞数量恢复到几乎先前的大小。部分肝切除术后因肝脏肥大旋转导致的胆管狭窄并不常见，其治疗方法仍存在争议。我们在2例因肝外伤行右肝叶切除术的患者中遇到了因左叶肥大旋转导致的肝外胆管狭窄。在此，我们介绍我们采用改良朗迈尔手术治疗该并发症的经验。
两名患者术后早期均未出现并发症。施行朗迈尔手术后，首例患者随访5个月，肝酶有一定升高，另一例患者随访14个月，肝功能检查正常。两名患者术后均完全无症状。
目前的经验表明，改良朗迈尔手术是治疗右肝叶切除术后因左叶肥大旋转导致胆管狭窄最有前景的手术方法。
