Grundmann R, Pichlmaier H
Langenbecks Arch Chir. 1983;359(3):181-90. doi: 10.1007/BF01250980.
52 patients with hepatic resection due to liver tumor, metastases, Echinococcus or liver trauma are reported. Hepatic resection represents a relatively harmless procedure in case of benign liver tumor; however, in case of a malignant disease, the prognosis after hepatic resection is impaired by the difficulty to predict the regeneration capability of the liver. The indication for the different operative procedures is being discussed. It is suggested to perform hepatic resection in the border lines of the liver lobes without extensive preparation of the liver hilus and to clamp the liver hilus during resection. If the liver hilus was occluded after steroid pretreatment, 40 min of hepatic ischemia were well tolerated without any consequences and intraoperative bloodloss could be reduced significantly.
报告了52例因肝肿瘤、转移瘤、肝包虫病或肝外伤而接受肝切除术的患者。对于良性肝肿瘤,肝切除术是一种相对无害的手术;然而,对于恶性疾病,肝切除术后的预后会因难以预测肝脏的再生能力而受到影响。文中讨论了不同手术方式的适应证。建议在肝叶边界进行肝切除术,无需对肝门进行广泛准备,并在切除过程中夹住肝门。如果在类固醇预处理后阻断肝门,40分钟的肝缺血耐受性良好,没有任何不良后果,且术中出血量可显著减少。