预结扎病侧肝脏入出肝血管切肝术的体会

目的　比较预结扎病侧肝脏入出肝血管切肝术与阻断肝门切肝术的优缺点。方法　 32例病人包括两组 :甲组 2 0例 ,肝切除时阻断肝门。乙组 12例 ,肝切除时预结扎病侧肝脏入出肝血管。对两组病人的术中失血量 ,术后平均出血量和引流量 ,术后肝功能恢复时间和术后并发症等进行比较分析。结果　甲乙两组术中平均出血量分别是 85 0ml和 4 5 0ml (P <0 0 1)。术后平均出血和引流量分别是 30 0ml和 15 0ml(P <0 0 1)。术后ALT恢复正常时间分别为 6～ 35d和 3～ 7d ,AST恢复正常时间分别是 5～ 30d和 4～ 8d ,总胆红素恢复正常时间分别为 7～ 6 0d和 5～ 14d ,两组相比差异显著 (P <0 0 1)。术后并发症发生率分别为 30 %和 0 % (P <0 0 1)。结论　预结扎病侧肝脏入出肝血管切肝术优于阻断肝门切肝术

Hepatectomy after preligation of hepatic inflow and outflow blood vessels on pathological side

Objective To compare the hepatectomy after preligation of hepatic inflow and outflow blood vessels on pathological side with Pringle maneuver. Methods A total of 32 patients were divided into 2 groups. In group A (n=20), Pringle maneuver was employed. In group B (n=12), hepatectomy after preligation of hepatic inflow and outflow blood vessels on the pathological side was used. The perioperative blood loss, postoperative bleeding and drainage, time of liver function returning to normal as well as incidence of postoperative complications were compared between the 2 groups. Results The mean perioperative blood loss, the mean amount of postoperative bleeding and drainage as well as incidence of postoperative complications were significantly higher but the recovering time o liver function markedly lower in group A than in group B (P<0.01). Conclusions Hepatectomy after preligation of hepatic inflow and outflow blood vessels on the pathological side is better than Pringle maneuver.