Monden Kazuteru, Sadamori Hiroshi, Hioki Masayoshi, Nakano Kanyu, Asami Shinya, Ohno Satoshi, Sasaki Kyo, Ueki Toru, Yabushita Kazuhisa, Uka Mayu, Hyodo Tsuyoshi, Sakaguchi Kousaku, Takakura Norihisa
Department of Gastroenterological Surgery, Fukuyama City Hospital, Fukuyama, Japan.
Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Japan.
Asian J Endosc Surg. 2017 Feb;10(1):100-103. doi: 10.1111/ases.12321.
The intra-operative detection of hepatocellular carcinoma (HCC) by ultrasonography is indispensable for laparoscopic partial hepatectomy. However, it is occasionally difficult to localize an HCC on an ultrasound in chronic liver disease. Two cases of partial hepatectomy using hookwire marking under CT guidance are presented.
The location of the HCC was identified by CT scan, and the puncture site was determined. A hookwire system, made of a stainless steel hook, was used to localize the HCC. The hookwire was placed percutaneously close to the HCC, and then the patient was taken to the operating room as soon as possible. After identification of the hookwire marker, the cutting line was determined on the liver surface to ensure a sufficient surgical margin in laparoscopic partial hepatectomy.
Two cases underwent these procedures with easy intra-operative marking of the resection area. This technique facilitates safe laparoscopic partial hepatectomy for an HCC that is invisible on ultrasound.
超声检查在术中检测肝细胞癌（HCC）对于腹腔镜肝部分切除术不可或缺。然而，在慢性肝病中，通过超声偶尔难以定位HCC。本文介绍了两例在CT引导下使用钩丝标记进行肝部分切除术的病例。
通过CT扫描确定HCC的位置，并确定穿刺部位。使用由不锈钢钩制成的钩丝系统来定位HCC。将钩丝经皮放置在靠近HCC的位置，然后尽快将患者送入手术室。在识别钩丝标记后，在肝脏表面确定切割线，以确保在腹腔镜肝部分切除术中获得足够的手术切缘。
两例患者接受了这些手术，术中切除区域的标记操作简便。该技术有助于对超声不可见的HCC进行安全的腹腔镜肝部分切除术。
