Houssin D, Massault P P, Pitre J, Ozier Y, Legmann P, Chapuis Y
Clinique Chirurgicale, Hôpital Cochin, Paris.
Gastroenterol Clin Biol. 1993;17(10):750-7.
Seven partial liver resections of at least six hepatic segments (five extended left hepatectomies, also called left trisegmentectomies, and two subtotal hepatectomies) were performed for tumor (of malignant nature in 6 cases). Six of seven patients were admitted for liver transplantation and one for liver resection. These procedures were performed under total vascular exclusion of the liver in six cases (with a veno-venous bypass in two cases) and with the Pringle maneuver in one case. Postoperative liver function was satisfactory in six cases whereas one patient died of hepatic failure on the tenth postoperative day. There was one bile duct stricture at eight months, after extended left hepatectomy. Four patients survived more than one year, three with hepatic tumor recurrence and one with distant metastases. Two patients were still alive, one after fourteen months with tumor recurrence in the liver, the other after seventeen months. In selected cases, partial hepatic resection of more than six segments can be performed for very large tumors. In cases of malignant tumors, a short period of survival with good quality of life can be offered to these patients.
为治疗肿瘤（6例为恶性肿瘤）实施了7例至少切除六个肝段的部分肝切除术（5例扩大左肝切除术，也称为左三叶切除术，以及2例次全肝切除术）。7例患者中有6例因肝移植入院，1例因肝切除术入院。其中6例手术在全肝血流阻断下进行（2例采用静脉-静脉转流），1例采用Pringle手法。6例患者术后肝功能良好，1例患者在术后第10天死于肝衰竭。扩大左肝切除术后8个月出现1例胆管狭窄。4例患者存活超过1年，3例出现肝肿瘤复发，1例出现远处转移。2例患者仍存活，1例在14个月时肝脏出现肿瘤复发，另1例在17个月时仍存活。在某些特定病例中，对于非常大的肿瘤可实施超过六个肝段的部分肝切除术。对于恶性肿瘤患者，可使其获得生存期短但生活质量良好的结果。
