[肝静脉及下腔静脉肝外控制在肝脏肿瘤患者复杂肝切除术中的作用及意义]
[Role and significance of extrahepatic control of hepatic vein and inferior vena cava in difficult hepatectomies for patients with liver tumors].
作者信息
Peng Shu-you, Liu Ying-bin, Xu Bin, Cai Xiu-jun, Mu Yi-ping, Wu Yu-lian, Cao Li-ping, Fang He-qing, Wang Jian-wei, Li Hai-jun, Li Jiang-tao, Wang Xin-bao, Deng Gui-long
机构信息
Department of General Surgery, Second Hospital, Medical College of Zhejiang University, Hangzhou 310009, China.
出版信息
Zhonghua Wai Ke Za Zhi. 2004 Mar 7;42(5):260-4.
OBJECTIVE
To explore the role of extrahepatic control on blood flow of hepatic vein and inferior vena cava in hepatectomy, and observe its effect on minimizing hemorrhage.
METHODS
From 2001 to April 2003, 33 patients who had liver tumors involving segment IV, VII, VIII or half liver underwent major hepatectomies that required exposure of the inferior vena cava and main trunks of hepatic veins, during which the major hepatic veins and inferior vena cava were isolated and taped to control blood flow when necessary.
RESULTS
In 33 attempts, 32 were successful and all tumors were resected successfully. The placement of occlusion tape was unsuccessful in 1 case. 7 cases did not need blood transfusion during operation. The amount of blood transfusion for other cases were form 0 to 1 600 ml. there was no operative mortality.
CONCLUSIONS
Appropriate control of main truck of hepatic vein and inferior vena cava is effective in reducing blood loss during hepatectomies. It is also very helpful for performing difficult hepatectomies.
目的
探讨肝外控制在肝切除术中对肝静脉及下腔静脉血流的作用，并观察其对减少出血的效果。
方法
2001年至2003年4月，33例肝脏肿瘤累及IV、VII、VIII段或半肝的患者接受了需要暴露下腔静脉和肝静脉主干的大肝切除术，术中分离并结扎主要肝静脉和下腔静脉，必要时控制血流。
结果
33次尝试中，32次成功，所有肿瘤均成功切除。1例放置阻断带失败。7例术中无需输血。其他病例输血量为0至1600毫升。无手术死亡。
结论
适当控制肝静脉主干和下腔静脉对减少肝切除术出血量有效。对进行困难的肝切除术也非常有帮助。
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