外侵性肝癌扩大切除术的术式探讨

目的：探讨外侵性肝癌扩大切除手术治疗的经验，以期提高手术成功率和患者的生存率。方法：回顾性分析１９９７年元月～１９９９年６月间施行扩大切除术的４１例外侵性肝癌的临床资料。结果：施行扩大切除术的４１例中除肝癌切除外，还包括联合切除：部分十二指肠１例，部分膈肌６例，右肾上腺２例，胆囊１８例，部分胃１例，右半结肠２例，脾脏２例。结论：严格掌握扩大切除术的指征，恰当地选择手术进路，同时注重病人的围手术期处理，是降低并发症、提高手术成功率及远期生存率的重要因素。

Extended Resection for Infiltrative Hepatocellular Carcinoma

To summarize the experience in extended resection for the treatment of infiltrative Hepato- cellular carcinoma(HCC). Methods: The clinical data of 41 patients with infiltrative HCC treated with ex- tended resection admitted from January 1997 to June 1999 were analysed retrospectively. Results: Extended resection was successfully performed in 41 cases, including combined partial duodenectomy in 1 case, partial diaphragmectomy in 6, right adrenalectomy in 2, cholecystectomy in 18, partial gastrectomy in 1, right transverse colectomy in 2, and splenectomy in 2. Conclusions: Under the prerequisite of following strict op- erative indications, choosing appropriate surgical approaches and paying attention to peri-operative care, extended resection might contribute to lowering the incidence of post-operative morbidity and improving the long-term survival rate of infiltrative HCC.