Reconstruction of Ⅴ and Ⅷ bepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation

Objective To summarize the experience of reconstruction of Ⅴ and Ⅷ hepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation. Methods The clinical data of 55 cases of living donor liver transplantation of right lobe without middle hepatic vein were analyzed, and Ⅴ and Ⅷ hepatic veins were reconstructed. All donors underwent evaluation on the basis of vascular anatomy, GRWR and graft volume/ESLV. Fifty-one grafts underwent reconstruction of Ⅴ and Ⅷ hepatic veins with cold-storage cadaveric iliac veins. Great saphenous vein, varicose umbilical veins, recipient intrahepatic portal veins and recipient intrahepatic veins were used respectively in the remaining 4 cases. Results One recipient died of obstruction of out-flow on the postoperative day 43. One recipient was converted to cadaver donor liver transplantation at the 7th day after operation, because of acute liver function failure. The remaining 53 cases recovered successfully. Conclusion Reconstruction of Ⅴ and Ⅷ hepatic veins with proper materials in right lobe (without middle hepatic vein) living donor liver transplantation is feasible, and the effect is satisfactory.     

Reconstruction of Ⅴ and Ⅷ bepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation

Objective To summarize the experience of reconstruction of Ⅴ and Ⅷ hepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation. Methods The clinical data of 55 cases of living donor liver transplantation of right lobe without middle hepatic vein were analyzed, and Ⅴ and Ⅷ hepatic veins were reconstructed. All donors underwent evaluation on the basis of vascular anatomy, GRWR and graft volume/ESLV. Fifty-one grafts underwent reconstruction of Ⅴ and Ⅷ hepatic veins with cold-storage cadaveric iliac veins. Great saphenous vein, varicose umbilical veins, recipient intrahepatic portal veins and recipient intrahepatic veins were used respectively in the remaining 4 cases. Results One recipient died of obstruction of out-flow on the postoperative day 43. One recipient was converted to cadaver donor liver transplantation at the 7th day after operation, because of acute liver function failure. The remaining 53 cases recovered successfully. Conclusion Reconstruction of Ⅴ and Ⅷ hepatic veins with proper materials in right lobe (without middle hepatic vein) living donor liver transplantation is feasible, and the effect is satisfactory.     

Reconstruction of Ⅴ and Ⅷ bepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation

Objective To summarize the experience of reconstruction of Ⅴ and Ⅷ hepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation. Methods The clinical data of 55 cases of living donor liver transplantation of right lobe without middle hepatic vein were analyzed, and Ⅴ and Ⅷ hepatic veins were reconstructed. All donors underwent evaluation on the basis of vascular anatomy, GRWR and graft volume/ESLV. Fifty-one grafts underwent reconstruction of Ⅴ and Ⅷ hepatic veins with cold-storage cadaveric iliac veins. Great saphenous vein, varicose umbilical veins, recipient intrahepatic portal veins and recipient intrahepatic veins were used respectively in the remaining 4 cases. Results One recipient died of obstruction of out-flow on the postoperative day 43. One recipient was converted to cadaver donor liver transplantation at the 7th day after operation, because of acute liver function failure. The remaining 53 cases recovered successfully. Conclusion Reconstruction of Ⅴ and Ⅷ hepatic veins with proper materials in right lobe (without middle hepatic vein) living donor liver transplantation is feasible, and the effect is satisfactory.     

Reconstruction of Ⅴ and Ⅷ bepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation

Objective To summarize the experience of reconstruction of Ⅴ and Ⅷ hepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation. Methods The clinical data of 55 cases of living donor liver transplantation of right lobe without middle hepatic vein were analyzed, and Ⅴ and Ⅷ hepatic veins were reconstructed. All donors underwent evaluation on the basis of vascular anatomy, GRWR and graft volume/ESLV. Fifty-one grafts underwent reconstruction of Ⅴ and Ⅷ hepatic veins with cold-storage cadaveric iliac veins. Great saphenous vein, varicose umbilical veins, recipient intrahepatic portal veins and recipient intrahepatic veins were used respectively in the remaining 4 cases. Results One recipient died of obstruction of out-flow on the postoperative day 43. One recipient was converted to cadaver donor liver transplantation at the 7th day after operation, because of acute liver function failure. The remaining 53 cases recovered successfully. Conclusion Reconstruction of Ⅴ and Ⅷ hepatic veins with proper materials in right lobe (without middle hepatic vein) living donor liver transplantation is feasible, and the effect is satisfactory.     

Reconstruction of Ⅴ and Ⅷ bepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation

Objective To summarize the experience of reconstruction of Ⅴ and Ⅷ hepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation. Methods The clinical data of 55 cases of living donor liver transplantation of right lobe without middle hepatic vein were analyzed, and Ⅴ and Ⅷ hepatic veins were reconstructed. All donors underwent evaluation on the basis of vascular anatomy, GRWR and graft volume/ESLV. Fifty-one grafts underwent reconstruction of Ⅴ and Ⅷ hepatic veins with cold-storage cadaveric iliac veins. Great saphenous vein, varicose umbilical veins, recipient intrahepatic portal veins and recipient intrahepatic veins were used respectively in the remaining 4 cases. Results One recipient died of obstruction of out-flow on the postoperative day 43. One recipient was converted to cadaver donor liver transplantation at the 7th day after operation, because of acute liver function failure. The remaining 53 cases recovered successfully. Conclusion Reconstruction of Ⅴ and Ⅷ hepatic veins with proper materials in right lobe (without middle hepatic vein) living donor liver transplantation is feasible, and the effect is satisfactory.     

Reconstruction of Ⅴ and Ⅷ bepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation

Objective To summarize the experience of reconstruction of Ⅴ and Ⅷ hepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation. Methods The clinical data of 55 cases of living donor liver transplantation of right lobe without middle hepatic vein were analyzed, and Ⅴ and Ⅷ hepatic veins were reconstructed. All donors underwent evaluation on the basis of vascular anatomy, GRWR and graft volume/ESLV. Fifty-one grafts underwent reconstruction of Ⅴ and Ⅷ hepatic veins with cold-storage cadaveric iliac veins. Great saphenous vein, varicose umbilical veins, recipient intrahepatic portal veins and recipient intrahepatic veins were used respectively in the remaining 4 cases. Results One recipient died of obstruction of out-flow on the postoperative day 43. One recipient was converted to cadaver donor liver transplantation at the 7th day after operation, because of acute liver function failure. The remaining 53 cases recovered successfully. Conclusion Reconstruction of Ⅴ and Ⅷ hepatic veins with proper materials in right lobe (without middle hepatic vein) living donor liver transplantation is feasible, and the effect is satisfactory.     

Reconstruction of Ⅴ and Ⅷ bepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation

Objective To summarize the experience of reconstruction of Ⅴ and Ⅷ hepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation. Methods The clinical data of 55 cases of living donor liver transplantation of right lobe without middle hepatic vein were analyzed, and Ⅴ and Ⅷ hepatic veins were reconstructed. All donors underwent evaluation on the basis of vascular anatomy, GRWR and graft volume/ESLV. Fifty-one grafts underwent reconstruction of Ⅴ and Ⅷ hepatic veins with cold-storage cadaveric iliac veins. Great saphenous vein, varicose umbilical veins, recipient intrahepatic portal veins and recipient intrahepatic veins were used respectively in the remaining 4 cases. Results One recipient died of obstruction of out-flow on the postoperative day 43. One recipient was converted to cadaver donor liver transplantation at the 7th day after operation, because of acute liver function failure. The remaining 53 cases recovered successfully. Conclusion Reconstruction of Ⅴ and Ⅷ hepatic veins with proper materials in right lobe (without middle hepatic vein) living donor liver transplantation is feasible, and the effect is satisfactory.     

Reconstruction of Ⅴ and Ⅷ bepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation

Objective To summarize the experience of reconstruction of Ⅴ and Ⅷ hepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation. Methods The clinical data of 55 cases of living donor liver transplantation of right lobe without middle hepatic vein were analyzed, and Ⅴ and Ⅷ hepatic veins were reconstructed. All donors underwent evaluation on the basis of vascular anatomy, GRWR and graft volume/ESLV. Fifty-one grafts underwent reconstruction of Ⅴ and Ⅷ hepatic veins with cold-storage cadaveric iliac veins. Great saphenous vein, varicose umbilical veins, recipient intrahepatic portal veins and recipient intrahepatic veins were used respectively in the remaining 4 cases. Results One recipient died of obstruction of out-flow on the postoperative day 43. One recipient was converted to cadaver donor liver transplantation at the 7th day after operation, because of acute liver function failure. The remaining 53 cases recovered successfully. Conclusion Reconstruction of Ⅴ and Ⅷ hepatic veins with proper materials in right lobe (without middle hepatic vein) living donor liver transplantation is feasible, and the effect is satisfactory.     

Reconstruction of Ⅴ and Ⅷ bepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation

Objective To summarize the experience of reconstruction of Ⅴ and Ⅷ hepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation. Methods The clinical data of 55 cases of living donor liver transplantation of right lobe without middle hepatic vein were analyzed, and Ⅴ and Ⅷ hepatic veins were reconstructed. All donors underwent evaluation on the basis of vascular anatomy, GRWR and graft volume/ESLV. Fifty-one grafts underwent reconstruction of Ⅴ and Ⅷ hepatic veins with cold-storage cadaveric iliac veins. Great saphenous vein, varicose umbilical veins, recipient intrahepatic portal veins and recipient intrahepatic veins were used respectively in the remaining 4 cases. Results One recipient died of obstruction of out-flow on the postoperative day 43. One recipient was converted to cadaver donor liver transplantation at the 7th day after operation, because of acute liver function failure. The remaining 53 cases recovered successfully. Conclusion Reconstruction of Ⅴ and Ⅷ hepatic veins with proper materials in right lobe (without middle hepatic vein) living donor liver transplantation is feasible, and the effect is satisfactory.     

Reconstruction of Ⅴ and Ⅷ bepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation

Objective To summarize the experience of reconstruction of Ⅴ and Ⅷ hepatic veins in right lobe (without middle hepatic vein) living donor liver transplantation. Methods The clinical data of 55 cases of living donor liver transplantation of right lobe without middle hepatic vein were analyzed, and Ⅴ and Ⅷ hepatic veins were reconstructed. All donors underwent evaluation on the basis of vascular anatomy, GRWR and graft volume/ESLV. Fifty-one grafts underwent reconstruction of Ⅴ and Ⅷ hepatic veins with cold-storage cadaveric iliac veins. Great saphenous vein, varicose umbilical veins, recipient intrahepatic portal veins and recipient intrahepatic veins were used respectively in the remaining 4 cases. Results One recipient died of obstruction of out-flow on the postoperative day 43. One recipient was converted to cadaver donor liver transplantation at the 7th day after operation, because of acute liver function failure. The remaining 53 cases recovered successfully. Conclusion Reconstruction of Ⅴ and Ⅷ hepatic veins with proper materials in right lobe (without middle hepatic vein) living donor liver transplantation is feasible, and the effect is satisfactory.     

3D打印技术在精准肝切除术前评估的应用

目的:探讨医学3D打印技术在精准肝切除术前评估的应用价值。方法:回顾性分析2016年1月—2016年12月在宁夏医科大学总医院肝胆外科7例复杂性肝脏肿瘤患者临床资料。其中男5例,女2例,平均年龄55岁。患者术前经上腹部增强CT扫描,使用三维可视化软件(MI-3DVS)进行三维重建,导入3D打印机,打印出1:1肝脏物理模型,分析肝脏解剖、进行术前模拟,确定手术方案。结果:全部患者的肝脏3D模型能清晰显示肝内脉管系统、肝脏及肿瘤组织解剖形态、肿瘤与肝内血管结构毗邻关系,计算出肝脏平均体积为(1 872.2±753.7)mL,肝脏肿瘤体积中位数为316.96 mL。根据3D打印结果,1例患者因肿瘤侵犯门静脉不适宜外科手术,建议行经肝动脉化疗栓塞术,其余6例均行精准肝切除,实际手术过程与术前手术规划完全符合(6/6),无围手术期期死亡。结论:医学3D打印技术可应用于肝脏肿瘤的手术规划,在精准肝切除的术前评估有一定的指导意义。     

门静脉和肝动脉结扎序贯二步法肝切除术治疗巨大肝癌

巨大肝癌切除术后剩余肝脏体积不足是发生肝衰竭的主要原因.通过阻断一侧的门静脉和肝动脉,使肿瘤降低分期,增加对侧术后剩余肝脏体积,成为目前切除巨大肝癌的方法之一.2013年3-4月厦门大学附属第一医院收治的1例原发性右半肝巨大肝癌患者,因肝脏剩余体积不足,术者一期行选择性门静脉及肝动脉结扎术后,序贯二期行肝切除术.患者2次手术均顺利完成,一期行门静脉右支及肝右动脉结扎术,术后肝肿瘤体积缩小,剩余左半肝代偿性增生良好,肝脏体积由术前488 mL增加到术后1个月689 mL.一期手术后33 d顺利实施二期巨大肝癌肝切除术,2次术后均无严重并发症发生.术后随访2个月,患者剩余肝脏未见肿瘤复发,AFP由术前425 mg/L降至26×10^-3mg/L.因此,选择性门静脉及肝动脉结扎后序贯二步法肝切除术可能是传统手术无法切除的巨大肝癌患者有效的治疗方法.     

三维可视化技术在评估残肝体积及指导肝切除中的应用研究

目的研究三维可视化技术在肝脏肿瘤术前评估及指导精准肝切除中的临床应用。方法采集10例入住我院的肝脏肿瘤患者术前64排螺旋CT亚毫米原始扫描数据,再运用腹部医学图像三维可视化系统(MI-3DVS)进行图像分割及三维重建,观察重建模型进而仿真手术,计算残肝体积百分比,结合患者临床资料评估手术风险,将仿真手术与真实手术全过程,术前风险评估及真实预后情况进行对比分析。结果 MI-3DVS对腹部脏器及其脉管系统三维重建的模型结构清晰、直观、形象逼真。10例患者功能肝体积介于(1335.28±293.72)ml;肿瘤体积介于(399.06±276.26)ml;残肝体积介于(770.12±226.77)ml;结合患者临床资料,10例患者术前测得的残肝体积百分比均能满足术后肝功代偿要求,仿真手术与真实手术全过程一致,术前利用MI-3DVS手术风险评估与真实手术风险一致。结论三维可视化技术对指导肝脏肿瘤手术方案的制定,提高肝脏肿瘤切除率,评估手术风险,降低手术并发症的发生率意义重大。     

医学图像三维可视化系统在肝胆管结石病诊断与治疗中的应用

目的 研究医学图像三维可视化系统(MI-3DVS)在肝胆管结石病诊断与治疗中的应用价值.方法 收集2008年8月至2010年8月南方医科大学珠江医院收治的54例肝胆管结石病患者的肝脏64排螺旋CT扫描原始数据,采用MI-3DVS进行肝脏及胆道三维重建.根据三维重建结果进行术前诊断和病理分型,以及多种手术方案的术前仿真演练,确定最佳手术方案.观察术中所见与仿真手术的符合程度以及患者结石残留情况.结果 54例患者中,病理分型Ⅰ型11例,Ⅱ型5例(其中Ⅱa型2例、Ⅱb型3例),E型38例;肝内胆管狭窄23例;伴萎缩-肥大综合征27例.肝内外胆管的立体解剖形态,病变胆管扩张及狭窄部位和程度,肝内胆管结石的部位、大小及数量可精确显示.仿真手术方案与实际手术的符合率为94%(51/54),51例择期手术患者术后无结石残留,全组术后结石残留率为6%(3/54).结论 MI-3DVS可实现肝胆管结石病的术前精确诊断和术中精细操作,可有效降低术后结石残留率.     

多模影像技术在解剖性肝切除手术导航中应用价值研究

目的 研究三维可视化（3DV）、吲哚菁绿荧光融合影像（FIGFI）、虚拟现实（VR）技术等多模影像技术在解剖性肝切除手术导航的应用价值。方法 选择2016年1月至2018年6月间南方医科大学珠江医院肝胆外科64例肝脏肿瘤病人临床资料。采用MI-3DVS对薄层CT图像数据进行个体化的肝脏、肝内脉管和肿瘤三维重建，并将三维重建模型导入VR开发引擎中转化为VR模型，指导术前规划和决策；术中使用荧光成像仪对肝脏、肿瘤进行侦测，并联合3DV和VR技术导航肝切除手术。结果 MI-3DVS三维重建的64例病人肝脏、肿瘤及肝内脉管等结构清晰；通过头戴式显示器及安装了捕捉手和手指运动的传感器的操纵手柄融入一个 3D-VR环境，更立体直观地显示前期3DV模型的沉浸感、空间感和立体感；FIGFI可进行肿瘤边界界定、肝切缘的界定、微小肝癌和肝切缘残留病灶的侦测。64例病人中，肝左外叶切除4例，肝左叶切除16例，肝右前叶切除5例，肝右后叶切除5例，肝右叶切除17例，肝中叶切除术5例，肝段切除11例（5段3例、6段6例、7段1例、8段1例），尾状叶切除1例。实际手术过程与术前手术规划一致。术后均未出现腹腔出血、胆漏、肝功能衰竭等严重并发症，围手术期无死亡病例。结论 多模影像技术在术前精确影像评估和术中导航解剖性、功能性、根治性肝切除手术具有重要应用价值。     

活体右半供肝Ⅴ和Ⅷ段静脉回流的重建方法

目的 总结活体右半供肝移植中,不含肝中静脉的右半供肝Ⅴ、Ⅷ段静脉回流的重建方法.方法 回顾性分析55例活体右半供肝移植中,不含肝中静脉的右半供肝Ⅴ、Ⅷ段静脉回流重建的临床资料.所有供者均通过了受者标准肝体积、供肝与受者体重比(GRWR)、供肝与受者标准肝体积比及供肝内血管解剖等指标的综合评估.供肝在切取、灌注及修整后,51例采用尸体髂静脉作为重建材料,其他4例分别采用受者的大隐静脉、曲张的脐静脉、肝内门静脉和肝静脉作为重建材料,以串联的方式重建供肝断面Ⅴ、Ⅷ段静脉回流.肝移植时,供肝肝右静脉与受者肝右静脉开口吻合,重建的Ⅴ、Ⅷ段静脉与受者肝中、肝左静脉汇合部吻合,供肝门静脉与受者门静脉右支或主干吻合.门静脉开放血流后依次重建肝动脉及胆道.术后对供、受者进行常规监测.结果 1例受者术后发生流出道梗阻,术后第43天死亡;1例受者术后第7天出现不明原因的急性重型肝组织坏死,行尸体供肝肝移植后痊愈.其余53例受者恢复顺利,术后4周时腹部CT检查显示重建的移植肝Ⅴ、Ⅷ段静脉回流通畅.55例供者术后均恢复顺利,术后2周出院.结论 不含肝中静脉的活体右半供肝Ⅴ、Ⅷ段静脉回流的重建在活体肝移植中是可行的,应选择合适的重建材料及手术方式.受者肝移植后临床效果良好.     

双源CT肝静脉和门静脉成像在经颈静脉肝内门体分流术术前的应用

目的探讨双源CT肝静脉和门静脉成像在经颈静脉肝内门体分流术（TIPS）前的临床应用价值。方法门静脉高压合并上消化道出血或大量腹水的28例肝硬化患者接受双源CT门静脉成像,采用最大密度投影（MIP）、多平面重建（MPR）、容积再现（VR）和表面遮盖显示（SSD）等后处理技术判断肝静脉及门静脉的显示情况、分支走行及二者的关系。结果 28例患者均成功完成双源CT肝静脉和门静脉成像,能够清晰显示肝静脉1～3级以上分支及门静脉的解剖变异,MIP、MPR及VR重建图像可以直观地评价门静脉和肝静脉的位置、管径,并了解门静脉高压侧支循环的分布范围和程度。双源CT门静脉成像有助于TIPS术前定位。结论双源CT门静脉成像是无创性检查门静脉和肝静脉的可靠方法 ,为TIPS术前制定个体化手术方案提供了依据,具有较高的临床应用价值。     

Selective ligation of portal vein and hepatic artery for ruptured hepatocellular carcinoma in a 13-year-old boy

Hepatocellular carcinoma (HCC) in children is rare, and the prognosis has been poor because of its advanced stage at diagnosis and unresponsiveness to chemotherapy. We report a 13-year-old boy with ruptured HCC in the left trisegment. When hemostasis of the ruptured surface was achieved in the emergency operation, the left branch of the portal vein and the left hepatic artery were ligated at the same time. The volume of the future liver remnant (FLR), that is, his right posterior sector, increased from 56% on admission to 70% of his standard liver volume on day 2. Blood level of serum protein induced by vitamin K absence or antagonist ?? started to decrease immediately. Left trisegmentectomy was successfully performed 10 days later, followed by chemotherapy. He has been well with a 2-year survival without recurrence. When the FLR is considered relatively small for a major hepatic resection, the selective ligation of the portal vein and the hepatic artery, which feed HCC, seems to be beneficial. This is because it may induce enlargement of the FLR, increasing the safety of the hepatectomy as preoperative portal vein embolization does before a major hepatectomy in adult patients with HCC, and the latter suppresses the tumor while waiting for the planned hepatectomy.     

循肝中静脉精准半肝切除疗效的前瞻性研究

目的 探讨循肝中静脉精准半肝切除术的疗效及术前肝静脉评估的应用价值.方法 前瞻性非随机对照分析2007年10月至2009年9月南京大学医学院附属鼓楼医院收治的68例行半肝切除术患者的临床资料.其中循肝中静脉的精准半肝切除术30例(精准组),传统解剖性半肝切除术38例(传统组).术前对精准组患者肝静脉进行评估分型.比较两组患者手术时间、术中出血量、输血量、肝功能、并发症发生率、住院时间等指标.计量资料采用t检验或秩和检验,计数资料采用x2和Fisher确切概率法进行分析.结果 精准组术前肝静脉评估Nakamura分型:Ⅰ型57%(17/30)、Ⅱ型27%(8/30)、Ⅲ型16%(5/30);Kawasaki分型:Ⅰ型37%(11/30)、Ⅱ型63%(19/30);保留肝中静脉右半肝切除13例、左半肝切除15例;不保留肝中静脉左半肝及右半肝切除各1例.精准组术中出血量、输血量、术后第3天ALT、TBil、胆碱酯酶、总住院时间、术后住院时间与传统组比较,差异无统计学意义(t=1.07,0.92,0.07,0.21,0.63,0.63,0.75,P＞0.05).精准组和传统组患者手术时间、术后第3天Alb、并发症发生率分别为(342±113)min、(35±3)g/L、40%(12/30)和(270±73)min、(33±3)g/L、66%(25/38),两组比较,差异有统计学意义(t=2.79,2.19,x2=4.49,P＜0.05).精准组和传统组肿瘤标本切缘阳性率分别为5%(1/19)和35%(8/23),两组比较,差异有统计学意义(P＜0.05).结论 术前通过肝静脉评估和分型,术中循肝中静脉的精准半肝切除可最大限度保留有完整静脉回流的功能性肝脏组织,保证合适的切缘,降低术后并发症发生率.     

虚拟肝切除技术在肝癌切除中的临床应用

目的 探讨虚拟肝切除技术在肝癌切除中的价值.方法 2007年9月至2008年9月对13例肝癌病人术前行常规Flash3D增强扫描,用3D-Doctor软件行包括下腔静脉、门静脉、肝静脉和肝短静脉的三维影像重建,测量全肝体积、肿瘤体积、拟切除的肝脏体积、余肝体积和余肝体积/标准肝体积(SFLVR).结果 7例行右半肝切除,6例肝段/叶切除.肝脏三维重建后均能从各个角度显示肝内静脉走向及与肿瘤的空间关系,肿瘤体积为(348±214)ml,拟切除肝体积为(676±375)ml,余肝体积为(714±261)ml,SFLVR为62%±19%.术后并发症包括肺1例肺部感染,中等量腹水6例,大量腹水2例,其中1例肝功能不全.结论 虚拟肝切除技术能直观显示肝脏静脉以及与肿瘤的关系,预测肝切除量,对制定肝脏手术方案具有实用价值.