Migliori G, Michelangeli F, Pras N, Fombaron G, Inglesakis J A
J Chir (Paris). 1977;113(5-6):487-96.
Lesions of the main hepatic veins constitute a special entity in the field of liver trauma. Their originality resides: in their immediate severity (difficulty of hemostasis) and secondary consequences (disturbance of the venous blood flow), in their frequent association with other traumatic lesions, The serious consequences of partial emergency hepatectomy which is the usual treatment. There are a number of factors which permit one to propose in a certain number of favourable cases, treatment of the wound or disinsertion of a hepatic vein by vascular ligature, or, preferably, reinsertion on the inferior vena cava after prior suture, associated with conservation of the hepatic parenchyma affected by the vascular lesion. This method seems to us particularly justified when there exist accessory hepatic veins undamaged during the trauma. The possibility of secondary complications cannot be excluded, but in the special case of severe multiple trauma, the immediate vital prognosis is more important than the risk of secondary complications and the difficulty of possible reoperation. Favoured by modern means of vascular exclusion of the liver, conservative treatment may have a place in lesions of the hepatic veins where emergency partial hepatectomy cannot be undertaken without a risk to life.
肝主静脉损伤在肝创伤领域是一种特殊情况。其特殊性在于：损伤即刻的严重性（止血困难）及继发性后果（静脉血流紊乱），常与其他创伤性损伤相关，以及作为常规治疗的部分急诊肝切除术的严重后果。有多种因素使得在一定数量的有利病例中，可通过血管结扎来处理肝静脉的伤口或离断，或者更优选地，在先行缝合后重新吻合至下腔静脉，并保留受血管病变影响的肝实质。当存在创伤时未受损的副肝静脉时，我们认为这种方法尤为合理。不能排除继发性并发症的可能性，但在严重多发伤的特殊情况下，即刻的生命预后比继发性并发症的风险及可能再次手术的难度更为重要。受现代肝脏血管阻断手段的支持，保守治疗在无法进行急诊部分肝切除术而无生命危险的肝静脉损伤中可能占有一席之地。
