Glisson蒂横断式肝切除术10例报告

目的总结应用Glisson蒂横断式肝切除术的经验。方法回顾性分析10例行Glisson蒂横断式肝切除术病人的临床资料,其中肝胆管结石7例,胆囊癌1例,肝癌2例。采用Glisson蒂横断式技术分别行右肝后叶切除术(Ⅵ+Ⅶ段)3例,右肝前叶(Ⅴ+Ⅷ段)切除1例,左外叶(Ⅱ+Ⅲ段)切除2例,Ⅲ段切除1例,左半肝(Ⅱ+Ⅲ+Ⅳ段)切除2例,局部肝切除(Ⅳb+Ⅴ段)1例。结果本组病例均成功实施Glisson蒂横断式肝切除术,术中无肝蒂Glisson鞘内管道损伤。手术时间平均4.6(3.2～6.5)h,术中失血量平均440(150～800)ml。术后无严重手术并发症和死亡病例,均痊愈出院。结论 Glisson蒂横断式肝切除术的理论基础在于对肝脏解剖分段新的认识,其操作简单、快速、安全,值得普遍推广应用。

Glissonean Pedicle Transection Method for Hepatic Resection(A Report of 10 Cases)

Objective To summarize the experiences of Glissonean pedicle transection method for hepatic resection.Methods The clinical data of 10 patients underwent hepatic resection using Glissonean pedicle transection method in our department were retrospectively analyzed,including 7 patients of hepatolithiasis,1 patient of gallbladder carcinoma and 2 patients of hepatocarcinoma.In the 10 patients,the operative procedures included the right posterior hepatolobectomy（Ⅵ＋Ⅶ,n=3）,the right anterior hepatolobectomy（Ⅴ＋Ⅷ,n=1）,the left lateral hepatolobectomy（Ⅱ＋Ⅲ,n=2）,the left hemihepatectomy（Ⅱ＋Ⅲ＋Ⅳ,n=2）,the segmentectomy of Ⅲ（n=1）and the combined segmentectomy of Ⅳb＋Ⅴ（n=1）.Results All of the 10 patients were successfully performed hepatic resection using Glissonean pedicle transection method without injury of the blood vessels or biliary ducts during operation.The average operative time was 4.6（3.2～6.5）h,and the mean blood loss was 440（150～800）ml.As a result,the patients had no serious postoperative complications and were all cured.Conclusions The theoretical basis for this hepatic resection method is the new understanding of surgical anatomy of the liver.It shows that the Glissonean pedicle transection method for hepatic resection is an easy,safe and prompt operation,which can be widely used in clinic.