Li Aijun, Pan Zeya, Zhou Weiping, Fu Siyuan, Yang Yuan, Huang Gang, Yin Lei, Cui Longjiu, Wu Bowen, Wu Mengchao
Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, 225 Changhai Street, 200438, Shanghai, China.
Surg Today. 2009;39(3):269-73. doi: 10.1007/s00595-008-3828-1. Epub 2009 Mar 12.
We describe a technique for isolating and excluding the hepatic veins during liver resection. First, the bare area near the right and left wall of the suprahepatic inferior vena cava (IVC) is dissected, exposing the right, left, and superior walls of the right hepatic vein (RHV) and the left-middle hepatic vein (LMHV). Two Satinsky clamps are used to clamp the roots of the right and common trunk of the LMHV, parallel to the IVC. It is not necessary to dissect the posterior wall of the hepatic veins. We used this method during major liver resection in 65 patients. The mean dissecting time of each hepatic vein was 7.31 +/- 3.6 min. No hepatic vein was lacerated during dissection and exclusion. The postoperative complication rate was 31.2%. Thus, the superior approach is a safe and easy maneuver when the posterior wall of the hepatic vein is difficult to dissect due to tumor invasion.
我们描述了一种在肝切除术中分离和排除肝静脉的技术。首先，解剖肝上下腔静脉（IVC）左右壁附近的裸区，暴露右肝静脉（RHV）和左中肝静脉（LMHV）的右壁、左壁和上壁。使用两个Satinsky钳平行于IVC夹住RHV根部和LMHV的共同主干。无需解剖肝静脉的后壁。我们在65例患者的大肝切除术中使用了这种方法。每条肝静脉的平均解剖时间为7.31±3.6分钟。解剖和排除过程中无肝静脉撕裂。术后并发症发生率为31.2%。因此，当肝静脉后壁因肿瘤侵犯难以解剖时，这种上入路是一种安全且简便的操作方法。
