解剖性肝切除治疗巨大肝血管瘤15例

目的总结本院13年中解剖性肝切除治疗巨大肝血管瘤15例的外科手术经验,探索最适合巨大肝血管瘤的手术方式。方法回顾性分析本院1999年~2011年解剖性肝切除治疗巨大肝血管瘤15例的临床资料。结果 15例均行解剖性肝切除术,包括右半肝切除术3例,左半肝切除术1例,右半肝切除及右侧尾状叶切除术1例,S6、7切除术4例,S7、8切除术1例,S4、7、8、1a切除术1例,S8切除术1例,S5、8切除术1例,S5、6切除术1例,S4、5、8切除术1例,手术均获成功。术中出血500~5 000 mL,术后1例出现伤口感染,1例出现胸腔积液,经治疗后痊愈,所有患者全部治愈出院。结论对于占据肝叶及多个肝段的巨大血管瘤,尤其是紧邻下腔静脉,选择解剖性肝切除治疗。

Anatomical hepatectomy in 15 cases of giant hepatic hemangioma

【Objective】 To review anatomical hepatectomy of 15 cases with giant hepatic hemangioma and to investigate the optimum surgical method of giant hepatic hemangioma.【Methods】 Anatomical hepatectomy of 15 cases with giant hepatic hemangioma was analyzed retrospectively.【Results】 All patients underwent anatomical hepatectomy,including left hemihepatectomy in 1 case,right hemihepatectomy in 3 cases,right hemihepatectomy and right caudate lobe resection in 1case,resection of S6,7 in 4 cases,resection of S7,8 in 1 case,resection of S4,7,8,1a in 1 case,resection of S8 in 1 case,resection of S5,8 in 1 case,resection of S5,6 in 1 case,resection of S4,5,8 in 1 case.The operations were successful.The intraoperative bleeding ranged from 500 to 5000 mL.One patient had wound infection.One patient had pleural effusion.All patients were discharged.【Conclusion】 The anatomical hepatectomy is the optimum surgical method of giant hepatic hemangioma occupying the lobe of the liver and multiple hepatic segment,especially closing to the inferior vena cava.