不规则肝切除治疗严重肝外伤的手术体会

目的探讨不规则肝叶切除在严重肝损伤中的应用价值。方法回顾性分析采用不规则肝叶切除治疗严重肝损伤33例。结果全组手术时间平均85(60～200)min,第一肝门阻断时间平均18(10～30)min。治愈29例,死亡4例。术后并发肝创面脓肿2例,经穿刺引流治愈;胆漏2例,1例经保守治疗治愈,1例保守治疗无效,经再次手术治愈。结论不规则肝切除治疗严重肝损伤手术操作相对简单,是行之有效的治疗手段。

Irregular Hepatectomy for Severe Hepatic Trauma

Objective To discuss the therapeutic effect of irregular hepatectomy for severe hepatic trauma. Method 33 cases of severe hepatic injury were treated with irregular hepatectomy. Results The mean operative time was 85 （60 - 200）minutes. And the mean blockage time of the primary hepatic hilum was 18（ 10 - 30）minutes. In all the 33 cases, there were 29 discharged without sequelae,and 4 died. The complications included 2 cases of liver abscess who were cured by puncture and drainage, and 2 cases of biliary leakage, one was cured by expectant treatment, and the other was cured by re-operation. Conclusion The irregular hepatectomy is a relatively simple and safe approach for severe hepatic trauma patients.