Division of Hepatobiliary & Pancreatic Surgery, & Liver Transplantation, Department of Surgery, The University of Hong Kong, & State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong, China.
Division of Hepatobiliary & Pancreatic Surgery, Department of Surgery, National University of Singapore, Singapore.
Int J Surg. 2020 Oct;82S:109-114. doi: 10.1016/j.ijsu.2020.06.050. Epub 2020 Jul 9.
Liver resection remains one of the most technically challenging surgical procedure in abdominal surgery due to the complex anatomical arrangement in the liver and its rich blood supply that constitutes about 20% of the cardiac output per cycle. The challenge for resection in cirrhotic livers is even higher because of the impact of surgical stress and trauma imposed on borderline liver function and the impaired ability for liver regeneration in cirrhotic livers. Nonetheless, evolution and advancement in surgical techniques as well as knowledge in perioperative management of liver resection has led to a substantial improvement in surgical outcome in recent decade. The objective of this article was to provide updated information on the recent developments in liver surgery, from preoperative evaluation, to technicality of resection, future liver remnant augmentation and finally, postoperative management of complications.
肝切除术仍然是腹部外科中技术要求最高的手术之一，这是由于肝脏的复杂解剖结构和丰富的血液供应，其每周期的血液供应约占心输出量的 20%。由于手术应激和创伤对边缘肝功能的影响以及肝硬化肝脏再生能力受损，肝硬化肝脏切除的难度更大。尽管如此，手术技术的发展和进步以及肝切除术围手术期管理知识的提高，使得近十年来手术结果有了实质性的改善。本文的目的是提供肝外科领域最新进展的最新信息，从术前评估、切除技术、剩余肝脏体积增加到术后并发症的处理。
