肝切除术并发流出道梗阻的防治

目的加深对流出道梗阻这一并发症的认识,提高复杂肝切除术的安全性。方法对5例肝切除术并发流出道梗阻的原因、临床表现和防治进行总结。结果5例肿瘤均位于第二肝门区,3例术中发生,表现为肝创面出血难止、肝肿大,经切除失去肝静脉引流的肝段后血止,术后恢复顺利;2例术后发生,表现为胸腹水、肝脾肿大、下肢水肿等典型布-加氏综合征症状,1例经内科保守治疗治愈,1例经球囊导管行血管狭窄段扩张治愈。结论术中预防流出道梗阻的关键是使主肝静脉（或下腔静脉）免受损伤性或压迫性狭窄;术后治疗的有效手段是用球囊对狭窄段行反复扩张或行内支架管置入术。

Prevention and treatment of hepatic venous outflow obstruction after hepatectomy

Objective To give an insight to hepatic venous outflow obstruction after hepatectomy and to improve the security of complicated hepatectomy. Methods The common causes,clinical manifestation,and preventive and therapeutic measures of hepatic venous outflow obstruction following hepatectomy were summarized. Results Liver tumors of five patients were all involved the second porta hepatis. Hepatic venous outflow obstruction was diagnosed in 3 patients with the common manifestation of hepatomegaly and unmanageab...