Seo Hyung-Il, Jo Hong Jae, Sim Mun Sup, Kim Suk
Department of Surgery, Postgraduate School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739, South Korea.
World J Gastroenterol. 2009 Jul 21;15(27):3437-9. doi: 10.3748/wjg.15.3437.
Hepatic hemangiomas need to be treated surgically in cases where they are accompanied with symptoms, have a risk of rupture, or are hardly distinguishable from malignancy. The present authors conducted embolization of the right hepatic artery one day before an operation for a huge hemangioma accompanied with symptoms and confirmed a decrease in its size. The authors performed a right trisegmentectomy through a J-shape incision, using a thoracoabdominal approach, and safely removed a giant hemangioma of 32.0 cm x 26.5 cm x 8.0 cm in size and 2300 g in weight. Even for inexperienced surgeons, a J-shape incision with a thoracoabdominal approach is considered a safe and useful method when right-side hepatectomy is required for a large mass in the right liver.
肝血管瘤在伴有症状、有破裂风险或难以与恶性肿瘤区分时需要进行手术治疗。本文作者在对一例伴有症状的巨大血管瘤进行手术前一天对右肝动脉进行了栓塞,并确认其大小有所减小。作者采用胸腹联合入路,通过J形切口进行了右三叶切除术,安全切除了一个大小为32.0 cm×26.5 cm×8.0 cm、重量为2300 g的巨大血管瘤。即使对于经验不足的外科医生来说,当右侧肝脏有较大肿块需要进行右肝切除术时,采用胸腹联合入路的J形切口被认为是一种安全且有用的方法。