Kim Y I, Kobayashi M, Aramaki M, Nakashima K, Akizuki S
First Department of Surgery, Oita Medical University, Japan.
Surg Today. 1994;24(4):328-32. doi: 10.1007/BF02348562.
We analyzed the results of hepatic resections performed during the past 5 years on 27 patients with active chronic liver diseases. The patients included 5 with chronic active hepatitis and 22 with active liver cirrhosis, all of whom had a serum alanine aminotransferase (ALT) level of more than 100 U/l on admission. Fourteen patients underwent hepatectomy by the conventional method (group 1), and 13 were treated by liver resection with portal triad occlusion (PTO) ranging from 32 to 75 min (group 2). The mean blood loss was significantly lower in group 2 than in group 1, being 630 versus 1,491 ml (P < 0.05). No serious complications developed in any of the group 2 patients, whereas liver failure occurred in three of the group 1 patients, two of whom died. The serum bilirubin levels were stabilized in group 2 from 14 days after surgery, whereas the values in group 1 remained elevated. These results indicate that prolonged hepatic inflow occlusion can be used during surgery in selected patients with active chronic liver diseases.
我们分析了过去5年中对27例活动性慢性肝病患者实施肝切除术的结果。患者包括5例慢性活动性肝炎患者和22例活动性肝硬化患者，所有患者入院时血清丙氨酸氨基转移酶（ALT）水平均超过100 U/l。14例患者采用传统方法进行肝切除术（第1组），13例采用门静脉三联阻断（PTO）32至75分钟的肝切除术进行治疗（第2组）。第2组的平均失血量明显低于第1组，分别为630 ml和1491 ml（P < 0.05）。第2组患者均未发生严重并发症，而第1组有3例患者发生肝衰竭，其中2例死亡。第2组患者术后14天血清胆红素水平稳定，而第1组患者的胆红素值仍持续升高。这些结果表明，对于选定的活动性慢性肝病患者，手术期间可采用延长肝血流阻断术。
