半离体切肝术的实验研究与临床应用

肝脏后方显露困难，使浸及第二肝门处以及包缗肝后段腔静脉的病灶难以得到根治性切除。故设想把肝脏“搬”出体外，切除病灶，再将其“还原”于腹腔内，作者以此为基础首次在临床上实行常温下半离体切肝术。本文着重介绍了动物实验中肝原位，肝离体两种术式的血液动力学和生化的改变，并重点讨论了肝上段腔静脉解剖，半离体切除肝术的操作要点。手术适应症及注意点，该技术的应用，使得一些常规方法不可能切除，肝原位无血切肝术难以

Experimental Studies and Clinical Application of Partial Extracorporeal Hepatectomy

lt is well known that tumors located at the second porta hepatis or arround the inferior vena ca-va are difficult to be resected radically because of the poor exposure of the liver on the back. According to thethought of removing the liver out of the abdominal cavity,resecting the tumor and then turning the liver back,experimental studies and frist clinical application of partial extracorporeal hepatectomy were performed by au-thors. In this paper the authors emphatically reported the hemodynamic and biochemical changes in the ortho-topic and extracorporeal hepatectomy,and made a comparison between them. The anatomy of the vena cavaabove liver were investigated,the main points and the in dications of the operation were discussed. It was foundthat by means of this technique tumors which surrounded by vena cava and could not be resected by ordinaryand orthotopic hepatectomy would be able to be cured by radical operation.