肝切除术技术综述。
A review of techniques for liver resection.
作者信息
Heriot A G, Karanjia N D
机构信息
Department of General Surgery, Royal Surrey County Hospital, Guildford, Surrey, UK.
出版信息
Ann R Coll Surg Engl. 2002 Nov;84(6):371-80. doi: 10.1308/003588402760978148.
BACKGROUND
There has been a significant increase in the number of hepatic resections performed. The aim of this review was to assess available techniques for liver resection and their application.
METHODS
A literature review was performed based on a Medline search to identify articles on liver resection. Keywords included liver resection, liver neoplasm, cancer, colorectal metastases and hepatocellular carcinoma.
RESULTS
Improved understanding of the segmental anatomy of the liver has resulted in the evolution of liver resection. The development of new approaches to the biliovascular tree, combined with clamping to produce ischaemic demarcation, has been important in demonstrating segmental boundaries for resection. The combination of methods of vascular control such as the Pringle manoeuvre and techniques of parenchymal resection such as ultrasonic dissection allows hepatic resection with minimal blood loss and morbidity.
CONCLUSIONS
Application of refined techniques for liver resection by specialised units allows liver resection to be performed on both normal and cirrhotic livers with low morbidity and mortality.
背景
肝切除术的实施数量显著增加。本综述的目的是评估现有的肝切除技术及其应用。
方法
基于医学文献数据库（Medline）检索进行文献综述，以识别有关肝切除的文章。关键词包括肝切除、肝脏肿瘤、癌症、结直肠癌转移和肝细胞癌。
结果
对肝脏分段解剖的深入理解推动了肝切除技术的发展。针对胆管血管树的新方法的发展，结合阻断以产生缺血界限，对于明确切除的分段边界至关重要。诸如Pringle手法等血管控制方法与诸如超声解剖等实质切除技术相结合，可使肝切除术中失血和发病率降至最低。
结论
专业单位应用精细的肝切除技术，可在正常肝脏和肝硬化肝脏上进行肝切除术，且发病率和死亡率较低。
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