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肝切除术后肝静脉流出道梗阻的新手术方法:一例报告。

Novel procedure for hepatic venous outflow block after liver resection: A case report.

作者信息

Higashi Hisanobu, Abe Yuta, Abe Kodai, Nakano Yutaka, Tanaka Masayuki, Hori Shutaro, Hasegawa Yasushi, Yagi Hiroshi, Kitago Minoru, Kitagawa Yuko

机构信息

Department of Surgery, National Hospital Organization Saitama Hospital, Wako 351-0102, Japan.

Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.

出版信息

World J Clin Cases. 2024 Oct 16;12(29):6320-6326. doi: 10.12998/wjcc.v12.i29.6320.

Abstract

BACKGROUND

Postoperative complications like remnant hepatic vein (HV) outflow block and liver torsion can occur after right hepatectomy. Hepatic falciform ligament fixation is typically used to prevent liver torsion. We report a novel procedure to manage outflow block.

CASE SUMMARY

An 80-year-old man developed HV outflow block after remnant right hepatectomy, despite liver fixation and intraoperative HV flow check. He had a history of cholangiocellular carcinoma and had undergone posterior segmentectomy and choledojejunostomy. The falciform ligament fixation was inadequate to maintain liver position. Emergency surgery was performed, using an omental flap and mobilized right side colon with ileocecal region to prevent liver dislocation due to intraabdominal adhesion. His postoperative course was uneventful.

CONCLUSION

This is the first report providing a novel surgical procedure when the falciform ligament is insufficient for remnant liver fixation.

摘要

背景

右肝切除术后可能会出现诸如残余肝静脉(HV)流出道梗阻和肝脏扭转等术后并发症。肝镰状韧带固定术通常用于预防肝脏扭转。我们报告一种处理流出道梗阻的新手术方法。

病例摘要

一名80岁男性在残余右肝切除术后发生了HV流出道梗阻,尽管进行了肝脏固定和术中HV血流检查。他有胆管细胞癌病史,曾接受过肝后段切除术和胆总管空肠吻合术。镰状韧带固定不足以维持肝脏位置。进行了急诊手术,使用网膜瓣和带回盲部的右侧结肠游离段来防止因腹腔内粘连导致的肝脏移位。他的术后过程顺利。

结论

这是第一份报告,介绍了在镰状韧带不足以固定残余肝脏时的一种新的手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8963/11372529/d4a624e2488a/WJCC-12-6320-g001.jpg

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