肝尾叶切除术26例报告

目的 总结２６例肝尾叶切除的经验。方法 使用多功能手术解剖器（ＰＭＯＤ）采取刮吸法断肝术施行肝尾叶切除２６例。其中原发性肝癌１８例,肝门胆管癌４例,胆囊癌、右肾上腺皮质腺癌肝转移、肝血管瘤和血管肉瘤各１例。属于单独尾叶切除者５例,联合右三叶切除１例,联合右半肝切除６例,联合左半肝切除９例,联合其他肝段切除５例。结果 手术均顺利完成。１例因肺梗塞于术后２周死亡,１１例分别于术后２￣３０个月因癌肿复发

Resection of caudate lobe of liver: report of 26 cases

OBJECTIVE: To summarize the experience in caudate lobectomy for 26 cases. METHODS: Caudate lobectomy was performed in 26 cases by Peng's multifunctional operative dissector (PMOD) to transect the liver parenchyma (Curettage and Aspiration technique). Primary liver cancer was noted in 18 cases, hilar cholangiocarcinoma in 4, gallbladder carcinoma in 1, right adrenocortical adenocarcinoma in 1, hepatoangioma in 1 and hepatoangiosarcoma in 1. Five cases underwent isolated caudate lobectomy, 1 combined caudate lobectomy with right trisegmentectomy, 6 combined caudate lobectomy with right hemihepatectomy, 9 combined caudate lobectomy with left hemihepatectomy, and 5 combined caudate lobectomy with segmentectomy. RESULTS: The operations were carried out successfully. Follow up for 2 - 23 months, 1 case died from pulmonary infraction 2 weeks after operation, 1 died from lung metastasis 2 months after operation, 10 died from tumor recurrence or metastasis 3, 11, 12, 15, 15, 15, 15, 19, 30, 30 months after operation respectively. The other 14 cases are still alive for 2 to 18 months. CONCLUSIONS: With PMOD, it is possible to dissect the structure precisely. Therefore the caudate lobe can be isolated from the three porta hepatis without much difficulty. Caudectomy can be performed safely.