肝切除治疗难切性肝癌178例报告

摘要

目的总结难切性肝癌的肝切除方法。方法 1994年6月至1999年6月应用逆行肝切除术切除癌灶巨大、显露困难或紧密粘连甚至侵犯相邻器官和累及下腔静脉的难切性肝癌178例(甲组)。同期用常规方法切除类似难切性肝癌31例用作对照(乙组)。结果两组均无围手术期死亡，甲组术中失血量为(1336±994)ml，乙组为(2286±1363)ml，P＜0.01，术后并发症发生率也明显低于乙组(P＜0.01) 。结论应用逆行肝切除术结合血管外科技术切除肝癌是安全和合适的。%Objective　To sum up the experience of difficult hepatectomy for liver cancer.MethodsRetrograde hepatectomy combined with vascular surgical technology was carried out in 178 patients with huge liver cancer,poor exposure,or involvement of IVC and adjacent organs (group A).During the same period classic hepatectomy was performed in 31 patients with similar local difficuties as control (group B).Results　There was no perioperative mortality.Intraoperative blood loss was significantly less in group A than that in group B (1336±994ml vs.2286±1363ml，P＜0.01).The postoperative complications rates were lower in group A than in group B (P＜0.01).Concluion　The retrograde hepatectomy combined with surgical skill are safe and suitable for difficult hepatectomy in liver cancer.