目的 探讨螺旋水刀在解剖性肝切除术中的应用价值.方法 对广东医学院附属医院2003年9月至2006年6月所实施的97例螺旋水刀解剖性肝切除病人的手术资料进行回顾性分析.结果 97例手术中有89例不需阻断肝门,断肝时间为15～45 min,断面处理时间为8～20 min,出血量在150～1200 ml之间(＜800 ml 93例,＞800 ml 4例);术中视野清晰,肝内管道系统暴露充分,未发生管道系统误损,术后B超监测未发现有重要血管损伤的表现;围手术期无死亡病例;术后肝功能恢复时间平均约为1周.结论 螺旋水刀解剖性肝切除术的应用是安全、可行的,能减少肝门血流阻断,减少术中出血量,缩短术后肝功能恢复时间.%Objective To evaluate the feasibility and value of helix hydro-jet in anatomical liver resection. Method The clinical data of 97 patients receiving anatomical liver resection using helix hydro-jet in our hospital from September 2003 to June 2006 were retrospectively analyzed. Results Eighty-nine of 97 the patients underwent interdict portal triad clamping. The liver resection duratio nwas 15--45 min. The disposal time of break-surface was 8-20 min. The intraoperative bleeding was 150-1200 ml (＜800 ml in 93 cases and ＞800 ml in 4). There was clear field during operation. The intrahepatic biliary tracts were completely exposed. There was no wrongly injured hepatic canal sys-tem. The postoperative monitoring by B-mode uhrasonography showed that no important blood vessels were damaged. There was no death during the perioperative period. All the patients recovered about 1 week after conservative therapy. Conclusion Application of helix hydro-jet in anatomical liver resec- tion is safe and feasible and can reduce portal triad clamping and bleeding volume. Meanwhile, it can shorten the average time of the recovery of liver function.
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