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肝脏手术中的出血:梳理预防方法

Bleeding in Hepatic Surgery: Sorting through Methods to Prevent It.

作者信息

Romano Fabrizio, Garancini Mattia, Uggeri Fabio, Degrate Luca, Nespoli Luca, Gianotti Luca, Nespoli Angelo, Uggeri Franco

机构信息

Unit of Hepatobiliary and Pancreatic Surgery, Department of Surgery, San Gerardo Hospital, University of Milan-Bicocca, Via Donizetti 106, 20052 Monza, Italy.

出版信息

HPB Surg. 2012;2012:169351. doi: 10.1155/2012/169351. Epub 2012 Nov 18.

DOI:10.1155/2012/169351
PMID:23213268
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3506885/
Abstract

Liver resections are demanding operations which can have life threatening complications although they are performed by experienced liver surgeons. The parameter "Blood Loss" has a central role in liver surgery, and different strategies to minimize it are a key to improve results. Moreover, recently, new technologies are applied in the field of liver surgery, having one goal: safer and easier liver operations. The aim of this paper is to review the different principal solutions to the problem of blood loss in hepatic surgery, focusing on technical aspects of new devices.

摘要

肝切除术是要求很高的手术,尽管由经验丰富的肝脏外科医生进行,但仍可能出现危及生命的并发症。“失血”参数在肝脏手术中起着核心作用,采用不同策略将失血降至最低是改善手术效果的关键。此外,近年来,新技术被应用于肝脏手术领域,其目标只有一个:使肝脏手术更安全、更简便。本文旨在综述肝手术中失血问题的不同主要解决方案,重点关注新设备的技术方面。

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本文引用的文献

1
Radiofrequency assisted liver resection: analysis of 604 consecutive cases.射频辅助肝切除术:604 例连续病例分析。
Eur J Surg Oncol. 2012 Mar;38(3):274-80. doi: 10.1016/j.ejso.2011.12.006. Epub 2011 Dec 30.
2
Minor hepatic resection for hepatocellular carcinoma in cirrhotic patients: Kelly clamp crushing resection versus heat coagulative necrosis with bipolar radiofrequency device.肝硬化患者肝细胞癌的小肝切除术:Kelly钳压榨切除术与双极射频设备热凝坏死术的比较
Am Surg. 2011 Nov;77(11):1490-5.
3
The efficacy of three transection techniques of the liver resection: a randomized clinical trial.肝切除三种横断技术的疗效:一项随机临床试验
Hepatogastroenterology. 2012 Jul-Aug;59(117):1501-6. doi: 10.5754/hge11552.
4
Bipolar vessel sealing system vs. clamp crushing technique for liver parenchyma transection.双极血管封闭系统与钳夹压榨技术在肝实质离断中的应用比较
Hepatogastroenterology. 2011 Jan-Feb;58(105):127-32.
5
Usefulness of the combination procedure of crash clamping and vessel sealing for hepatic resection.肝切除术中阻断夹闭与血管封闭联合操作的效用
J Surg Oncol. 2010 Aug 1;102(2):179-83. doi: 10.1002/jso.21575.
6
Gyrus PlasmaKinetic bipolar coagulation device for liver resection.用于肝切除的回旋等离子体动力双极凝血装置。
ANZ J Surg. 2010 Mar;80(3):182-5. doi: 10.1111/j.1445-2197.2009.05091.x.
7
Combined blunt-clamp dissection and LigaSure ligation for hepatic parenchyma dissection: postcoagulation technique.联合钝性夹闭与 Ligasure 结扎行肝实质离断:止血后技术。
J Am Coll Surg. 2010 Jan;210(1):39-44. doi: 10.1016/j.jamcollsurg.2009.09.035. Epub 2009 Nov 18.
8
Surgery in the patient with liver disease.
Anesthesiol Clin. 2009 Dec;27(4):721-37. doi: 10.1016/j.anclin.2009.09.007.
9
The vessel sealing system (LigaSure) in hepatic resection: a randomized controlled trial.肝脏切除术中的血管闭合系统(LigaSure):一项随机对照试验。
Ann Surg. 2009 Aug;250(2):199-203. doi: 10.1097/SLA.0b013e3181a334f9.
10
Utility of the Gyrus open forceps in hepatic parenchymal transection.Gyrus 开腹器在肝实质切开术中的应用。
HPB (Oxford). 2009 May;11(3):258-63. doi: 10.1111/j.1477-2574.2009.00048.x.