选择性半肝血流阻断在大肝癌切除术中的应用

目的：探讨选择性半肝血流阻断方法在大肝癌切除术中的临床意义。
方法：回顾性分析近3年来40例大肝癌切除术患者的临床资料，40例术中均采用选择性阻断肿瘤侧半肝入肝血流和出肝血流的方法。
结果：40例大肝癌切除均顺利完成。术中出血量100~800 mL，平均360 mL。25例术中未输血。手术时间90~150 min，平均116 min；术后恢复良好并痊愈出院，无肝功能衰竭及其他严重并发症，无围手术期死亡。
结论：选择性半肝血流阻断是一种安全有效的肝血流阻断方法，其具有控制出血确切、肝功能损害小、避免肠黏膜屏障损伤、防止空气栓塞和肿瘤播散转移的优点，适用于合并肝硬化的大肝癌或巨大肝癌的切除。

Selective hemihepatic vascular occlusion in hepatectomy for large hepatocellular carcinomas

Objective:To evaluate the clinical values of selective hemihepatic vascular occlusion in hepatectomy for large hepatocellular carcinomas.
Methods:Forty patients with large hepatocellular carcinomas who underwent hepatectomy with selective hepatic inflow and outflow occlusion of tumor-bearing liver were retrospectively analyzed.
Results:All the 40 patients underwent hepatectomy successfully. The blood losts during the operation was 100-800 mL (average 360 mL). The operation time was 90-150 min(average 116 min). Intraoperative blood transfusion was not performed in twenty-five patients. All patients recovered completely and were discharged without liver function failure or other severe complications. There was no perioperative death.
Conclusions:Selective  hemihepatic vascular occlusion in hepatectomy for large hepatocellular carcinomas is a safe and effective method with advantages of controlling hemorrhage,  decreasing liver damage and gut barrier injury, avoiding air embolism and preventing metastasis.