原发性肝癌合并门静脉高压、脾亢的外科治疗

原发性肝癌多在肝炎后肝硬化的基础上发生,肝癌合并门静脉高压及脾亢在临床上较常见,对于适合的患者在外科治疗肝癌的同时一并处理门静脉高压脾亢成为可能,肝癌局部根治性切除附加门奇断流、脾切除已成为目前最佳的方法。如何选择最佳处理方案,降低手术风险,减少并发症并延长生命,是肝脏外科的热点之一,如何安全合理地同期实施肝癌切除+脾切除+门奇断流术以期达到肝癌、门静脉高压症及脾亢联合治疗的理想目的,国内外许多学者作了有益的探索,本文就此作一综述。

The Surgical Treatment of Primary Hepatocellular Carcinoma with Portal Hypertension and Hypersplenism

Most of primary hepatocellular carcinoma happened based on the occurrence of posthep- atitic Cirrhosis. Hepatocellular carcinoma with portal hypertension and hypersplenism are common in clinical practice. Local radical excision of hepatoma plus portaazygous devascularization , splenectomy has become the best way. Many scholars have made much exploration on how to achieve a effective com- bination therapy of hepatocellular carcinoma with portal hypertension by hepatectomy, splenectomy and devascularization. In this article, the present status of surgery treatment in primary hepatoceUular carcinoma with portal hypertension and hypersplenism are reviewed.