Tanaka Hiromu, Takemura Shigekazu, Ohba Kazuki, Hai Seikan, Ichikawa Tsuyoshi, Kodai Shintaro, Shinkawa Hiroji, Shuto Taichi, Hirohashi Kazuhiro, Kubo Shoji
Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka 545-8585, Japan.
Hepatogastroenterology. 2008 Jan-Feb;55(81):160-3.
BACKGROUND/AIMS: The liver hanging maneuver is widely used in right lobectomy to resect huge tumors and harvest living donors. The convenience of tape assistance in other types of hepatectomy is not well known.
Tape-guiding technique (TGT) was applied in 30 hepatectomies of different type between April 2003 and April 2006. The indications were liver carcinoma in 22 and living-donor in 8. Hepatectomies included right lobectomy, 14; left lobectomy with caudate lobectomy, 8; left lobectomy without caudate lobectomy, 2; lateral segmentectomy, 3; central bisegmentectomy, posterior segmentectomy, and superior dorsal partial resection, 1 each. A tape was placed in front of the inferior vena cava for right hepatectomy and left hepatectomy with caudate lobectomy. In other hepatectomies, the tape was positioned to be the target of parenchymal dissection.
TGT was successfully performed in all 30 cases. Tape facilitated dissection by helping the surgeon maintain orientation, and traction on the tape flattened the parenchyma, making it easier to identify and manage vessels and ducts. With an assistant holding the tape, the surgeon's left hand was free, and ligation and suturing was easier and more secure.
The TGT is a convenient technique that is applicable to different types of liver resection.
背景/目的：肝脏悬吊法在右半肝切除术中广泛用于切除巨大肿瘤及获取活体供肝。胶带辅助在其他类型肝切除术中的便利性尚不为人所知。
2003年4月至2006年4月期间，对30例不同类型的肝切除术应用了胶带引导技术（TGT）。适应证为肝癌22例，活体供肝8例。肝切除术包括右半肝切除术14例；左半肝切除联合尾状叶切除术8例；左半肝切除不联合尾状叶切除术2例；肝左外叶切除术3例；肝中央双段切除术、肝右后叶切除术及肝上背侧部分切除术各1例。对于右半肝切除术及左半肝切除联合尾状叶切除术，在肝下腔静脉前方放置一条胶带。在其他肝切除术中，将胶带放置在肝实质离断的目标位置。
所有30例均成功实施TGT。胶带有助于术者保持方向从而便于解剖，牵拉胶带可使肝实质变平，更易于识别和处理血管及胆管。在助手牵拉胶带时，术者左手得以解放，结扎和缝合更简便且更安全。
TGT是一种适用于不同类型肝切除术的便捷技术。
