Ou Jiang, Yu Liu, Nan-Sheng Cheng
Department of Biliary Surgery, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041 China.
Department of Surgical Oncology, The Second People's Hospital of Neijiang, Neijiang, Sichuan Province 641100 China.
Indian J Surg. 2017 Oct;79(5):461-463. doi: 10.1007/s12262-017-1608-0. Epub 2017 Mar 1.
A 32-year-old man was admitted to our hospital due to a traffic accident. Intraoperative observations revealed hemoperitoneum, splenic transection, pancreatic tail contusion, comminuted injury in the porta hepatis, rupture in the left hepatic duct, an irregular crevasse in the ductus hepaticus communis, the caudate lobe was transversely broken on the left, and under the gap, there was a fracture in retrohepatic inferior vena cava with huge retroperitoneal hematoma. We carried out a ligation of the left hepatic duct and the proper hepatic artery. Postoperation, the man recovered smoothly. At 5 years and 5 months postoperation, MRI showed that the left liver had atrophied partly. So, we consider that the ligation of the left hepatic duct is a safe procedure for patients without cirrhosis under the conditions of ligation of the proper hepatic artery.
一名32岁男性因交通事故入院。术中观察发现有腹腔积血、脾破裂、胰尾挫伤、肝门部粉碎性损伤、左肝管破裂、肝总管不规则裂伤、尾状叶左侧横向断裂,裂口下方肝后下腔静脉骨折并伴有巨大腹膜后血肿。我们对左肝管和肝固有动脉进行了结扎。术后患者恢复顺利。术后5年5个月时,MRI显示左肝部分萎缩。因此,我们认为在肝固有动脉结扎的情况下,对于无肝硬化的患者,左肝管结扎是一种安全的手术方式。