Nishida O, Satoh N, Alam A S, Uchino J
First Department of Surgery, Hokkaido University School of Medicine, Kitaku Sapporo, Japan.
Am Surg. 1988 Aug;54(8):483-6.
During the past 19 years, 52 cases of hepatic cavernous hemangioma have been treated at our institution. Thirty patients underwent hepatic resection. In six patients, the extensive tumor mass invaded multiple segments or both lobes of the liver and complete resection was deemed hazardous. Therefore, hepatic artery ligation was carried out. In all six cases the hemangioma occupied more than two segments. Right hepatic artery ligation was done in five patients and left hepatic artery ligation in one. All are doing well without complication. The longest follow-up is 19 years and the shortest 2 years and 2 months following operation. Four patients have been followed for more than 4 years and in all patients there are no residual complaints. Computerized tomography (CT) revealed the reduction of the tumor size after arterial ligation. One patient suffered from cholecystolithiasis 9 years after hepatic artery ligation, and at the time of cholecystectomy, a biopsy and microscopic examination of the lesion revealed evidence of fibrotic degeneration of the hemangioma. These findings indicate the effectiveness of hepatic artery ligation for treatment of hepatic cavernous hemangioma that are judged hazardous to resect.
在过去19年中，我院共治疗了52例肝海绵状血管瘤患者。30例患者接受了肝切除术。6例患者的巨大肿瘤侵犯了肝脏的多个肝段或两叶，被认为无法进行完整切除。因此，对这6例患者实施了肝动脉结扎术。所有6例患者的血管瘤均占据两个以上肝段。5例患者进行了右肝动脉结扎，1例进行了左肝动脉结扎。所有患者术后情况良好，无并发症发生。术后最长随访时间为19年，最短为2年零2个月。4例患者的随访时间超过4年，所有患者均无残留不适主诉。计算机断层扫描（CT）显示动脉结扎后肿瘤体积缩小。1例患者在肝动脉结扎9年后发生胆囊结石，在胆囊切除时，对病变进行活检和显微镜检查发现血管瘤有纤维变性迹象。这些结果表明，肝动脉结扎术对于那些被认为切除有风险的肝海绵状血管瘤是有效的。
