Stephen M S, Sheil A G, Thompson J F, Wilson T, Boland S L
Department of Surgery, Royal Prince Alfred Hospital, Australia.
Arch Surg. 1990 Nov;125(11):1482-5. doi: 10.1001/archsurg.1990.01410230076013.
Occlusion of the supraceliac abdominal aorta and hepatic vascular isolation were employed in a series of 15 patients as a definitive method to allow avascular hepatic resection. The series was compared with an earlier group of patients treated conventionally. In the avascular hepatic resection group there was no mortality; hypotension did not occur at the time of hepatic vascular isolation; rapid, accurate excision of the hepatic lesions could be achieved in a bloodless field; resection of midline lesions and those involving the great veins was possible; and "segmentectomies," or resections crossing segmental boundaries, could be performed where previously formal hepatic lobectomies were required. Concomitantly, the greatest amount of uninvolved hepatic parenchyma remained in situ. There was increased ease of operative management, reduced blood loss, and reduced operating time (mean, 2.8 hours).
对15例患者采用腹腔干上方腹主动脉阻断和肝血管隔离术作为一种确定性方法，以实现无血肝切除术。将该系列患者与早期接受传统治疗的一组患者进行比较。在无血肝切除组中，无死亡病例；肝血管隔离时未发生低血压；可在无血视野中快速、准确地切除肝脏病变；可以切除中线病变和累及大静脉的病变；并且在以前需要进行正规肝叶切除术的情况下，可以进行“节段切除术”，即跨越节段边界的切除术。同时，最大限度地保留了未受累的肝实质。手术操作更加简便，失血量减少，手术时间缩短（平均2.8小时）。
