Nishizaki T, Matsumata T, Kamakura T, Adachi E, Sugimachi K
Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Hepatogastroenterology. 1995 Feb;42(1):5-8.
The functional reserve of the liver should be estimated prior to hepatectomy. While the experienced liver surgeon often relies on the findings of manual palpation intra-operatively, this approach remains a subjective one. In 22 of our patients scheduled for hepatectomy, we measured intra-operatively hepatic consistency as well as the parameters of liver function. Hepatic consistency is augmented during progression from non-fibrosis to cirrhosis. We found a statistically significant correlation between liver consistency and the indocyanine green retention rate at 15 minutes (r = 0.682; p = 0.0009) and portal vein pressure (r = 0.733; p = 0.0008). Prothrombin time, the hepaplastin test, total bilirubin and glutamic pyruvic transaminase showed no significant correlation with hepatic consistency. The safety limits of the hepatic blood circulation for the performance of hepatectomy can be estimated using parameters of consistency in this organ.
肝切除术之前应评估肝脏的功能储备。经验丰富的肝脏外科医生通常在术中依靠手法触诊的结果,但这种方法仍然是主观的。在我们计划进行肝切除术的22例患者中,我们在术中测量了肝脏的质地以及肝功能参数。从无纤维化发展到肝硬化的过程中,肝脏质地会增强。我们发现肝脏质地与15分钟时的吲哚菁绿滞留率(r = 0.682;p = 0.0009)和门静脉压力(r = 0.733;p = 0.0008)之间存在统计学上的显著相关性。凝血酶原时间、肝促凝血酶原激酶试验、总胆红素和谷丙转氨酶与肝脏质地无显著相关性。利用该器官的质地参数可以估计肝切除术时肝脏血液循环的安全限度。