肝尾叶肝癌28例的手术切除体会

Ofbjective:To analyze the operative technique and results of the resection for caudate lobe carcinoma of the liver. Methods:The liver was fully freed of the ligments,short hepatic veins were divided and sutured,and the tumor was then freed frum the inferior vena cava(IVC).The caudate lobe was resected alone or in combination with other segment. Results:28 patients underwent resection of caudate lobe tumor.The number of the short hepatic veins transected and tied was 2-5(mean 3).An intermittent Pringle‘s manoeuver was used in 26patients with a median occlusion time of 21.7(range10-32)min.The median blood loss was 574(range100-1300)ml.No major complications such as massive bleeding and diliary fistula occurred.Intraoperative total vascular occlusion was perfored on lnly 5 cases.All patients were discharged from the hospital.Outpatient periodic TAEplus chemotherapy was performed.Postoperative recurence and metastasis was found in 13 cases,with 5 deaths. Conclusion:The use of third porta hepatis dissection for resection of the caudate lobe tumor can reduce the risk of massive bleeding during the operation and can raise the rate of resection of caudate lobe tumor.

Resection of the caudate lobe tumor of liver

Objective To analyze the operative technique and results of the resection for caudate lobe carcinoma of the liver. Methods The liver was fully freed of the ligments, short hepatic veins were divided and sutured, and the tumor was the freed from the inferior vena cava (IVC). The caudate lobe was resected alone or in combination with other segment. Results 28 patients underwent resection of caudate lobe tumor. The number of the short hepatic veins transected and tied was 2–5 (mean 3). An intermittent Pringle's manoeuver was used in 26 patients with a median occlusion time of 21.7 (range 10–32) min. The median blood loss was 574 (range 100–1300) ml. No major complications such as massive bleeding and biliary fistula occurred. Intraoperative total vascular occlusion was perfored on only 5 cases. All patients were discharged from the hospital. Outpatient periodic TAE plus chemotherapy was performed. Postoperative recurrence and metastasis was found in 13 cases, with 5 deaths. Conclusion The use of third porta hepatis dissection for resection of the caudate lobe tumor can reduce the risk of massive bleeding during the operation and can raise the rate of resection of caudate lobe tumor.