Florida Hospital Tampa, Tampa, FL, USA; University of Central Florida, Orlando, FL, USA.
Florida Hospital Tampa, Tampa, FL, USA.
Am J Surg. 2020 Jan;219(1):106-109. doi: 10.1016/j.amjsurg.2019.05.007. Epub 2019 May 23.
Hepatectomy is the gold standard curative treatment for hepatic neoplasms in patients with preserved liver function. Many large tumors require extended hepatectomy (EH). Possibility of developing major postoperative complications including liver failure is feared by many surgeons. We aim to describe our outcomes of EH for large hepatobiliary tumors.
All patients undergoing hepatectomy between 2012 and 2017 were prospectively followed.
91 patients underwent hepatectomy with ten patients underwent EH. The majority of patients were women, age of 63, BMI of 24, and MELD score of 11. Six patients underwent an extended right hepatectomy, while four patients underwent extended left hepatectomy. Operative time was 224 min with estimated blood loss of 500 ml. No intraoperative complications were seen. Two patients experienced postoperative complications (pleural effusion in one patient and respiratory failure in another). Length of ICU stay was 2 days, and hospital stay was 5 days. 80% of the patients are currently alive with median follow-up of 41.2 months.
EH can be undertaken safely with acceptable morbidity and mortality in our center.
肝切除术是肝功能正常患者治疗肝肿瘤的金标准。许多大肿瘤需要进行扩大肝切除术（EH）。许多外科医生担心会发生包括肝功能衰竭在内的主要术后并发症。我们旨在描述我们对大肝胆肿瘤进行扩大肝切除术的结果。
前瞻性随访了 2012 年至 2017 年间接受肝切除术的所有患者。
91 例患者接受了肝切除术，其中 10 例患者接受了 EH。大多数患者为女性，年龄 63 岁，BMI 为 24，MELD 评分为 11。6 例患者接受了扩大右半肝切除术，4 例患者接受了扩大左半肝切除术。手术时间为 224 分钟，估计出血量为 500 毫升。术中无并发症发生。有 2 例患者发生术后并发症（1 例患者发生胸腔积液，另 1 例患者发生呼吸衰竭）。入住 ICU 的时间为 2 天，住院时间为 5 天。80%的患者目前存活，中位随访时间为 41.2 个月。
在我们中心，EH 可以安全进行，其发病率和死亡率可接受。
