不同入肝血流阻断法在肝癌切除术中的应用

目的 探讨选择性Glisson鞘外阻断法和第一肝门阻断(Pringle)法在肝癌切除术中的价值.方法 回顾性分析2012年5月至2021年5月在河池市第三人民医院普通外科收治的93例原发性肝癌患者的临床资料,按照术中入肝血流阻断方式分组,对照组行Pringle法(n=46),观察组行选择性Glisson鞘外阻断法(n=...

Application of different hepatic blood flow occlusion methods in liver cancer resection

 Objective To investigate the value of the selective Glisson's pedicle transection method and the first portal occlusion (Pringle) method in liver cancer resection. Methods The clinical data of 93 patients with primary liver cancer in the Third People's Hospital of Hechi from May 2012 to May 2021 were retrospectively analyzed. The patients were divided into two groups according to the adopted intraoperative hepatic blood flow occlusion method. The control group received the Pringle method (n=46), and the treatment group received selective Glisson's pedicle transection method (n=47). The evaluation indexes included intraoperative blood loss, duration of operation, postoperative albumin input, alanine aminotransferase (ALT), total bilirubin (TBIL), anal exhaust time and hospital stay, and so on. Results There were no significant differences in duration of operation and blood loss between two groups (all P>0.05). The postoperative albumin input, ALT and TBIL in the treatment group were lower than those in the control group on the 1st, 3rd, 5th, 7th and 10th day after surgery (all P<0.05). The time of postoperative anal exhaust and hospitalization in the treatment group were shorter than those in the control group (all P<0.05). The main complications in two groups were abdominal or pleural effusion, lung infection and atelectasis, but there was no statistically significant in the incidence (all P>0.05). Conclusions In liver cancer resection, the selective Glisson's pedicle transection method is comparable to Pringle method, but with less postoperative liver function damage, faster gastrointestinal function recovery, shorter hospital stay and no increase in postoperative complications. Further randomized controlled trials are necessary.