经裸区肝脏悬吊法行右肝巨大肿瘤切除术

Belghiti等于2001年首次提出肝脏悬吊法经前入路行右半肝切除术，但由于其在肝后下腔静脉前方盲目建立隧道过程中，易撕裂肝短静脉和肝实质引起出血，难以推广。此后陈孝平等建立一种新的肝脏悬吊技术，即沿腔静脉右侧肝后间隙经肝裸区做隧道置悬吊技术。该方法简单、安全，能充分显露深部肝断面，便于止血，尤其是可有效控制来自肝静脉分支的出血。本文介绍我们应用经裸区肝脏悬吊法行右肝巨大肿瘤右半肝切除的经验，并就其相关的解剖学要点，操作要领以及术中应注意的问题进行讨论。

Right hemi-hepatectomy for huge liver tumor using transbare-area liver hanging maneuver

As a safer approach to right hemi-hepatectomy exposure of deeper parenchymal tissue during liver transaction, a liver-hanging maneuver（LHM）of tightening for huge liver tumor was proposed by Belghiti et al in 2001. However, this procedure is perforrn, ed blindly, there are potential risks of damaging small retrohepatic veins and consequential bleeding. To overcome this dilemma, Chen XP et al modified the procedure as transbare-area liver hanging maneuver （TBLHM）. Retrohe- patic space tunneling was developed to the right of IVC. Then a tape could be passed around liver parenchyma to elevate liver away from IVC. And upward traction of tape allow better hemostasis of transection surface, especially for bleeding from branchbs of hepatic veins. Our experiences of right hemihepatectomy for huge liver tumor via TBLHM were summarized. In addition, anatomical essentials and major technical aspects of mobilization of right hepatic lobe were included.