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肝细胞腺瘤是一罕见的良性肿瘤,自引进口服避孕药以来,其发病率有所增加。这种肿瘤主要见于育龄期妇女,多数有症状。治疗上存在着争论:①分类紊乱,特别是与局灶性结节状增生之间的区分。②腺瘤并发出血的发生率难于估计。③癌变的发生率至今不确切。④遇到困难,迫使采取广泛切除的原则。本文探讨确定治疗方案的参数,描述手术的切除,并试图确定适应证和手术切除肿瘤的合理途径。 1976～1987年期间巴黎Paul Brousse医院共确诊24例肝腺瘤,年龄4～45岁,本文复习了病人的临床记录。用Couinaud解剖学分类描述肝内肿瘤的形态学。20例作腹腔肠系膜血管造影以及肝超声扫描以确定肿瘤的血管关系。
Hepatocyte adenoma is a rare benign tumor that has increased in incidence since the introduction of oral contraceptives. This type of tumor is mainly seen in women of childbearing age, and most have symptoms. There is controversy in the treatment: 1 Disorders, especially the distinction between focal nodular hyperplasia. 2 The incidence of adenomas and bleeding is difficult to estimate. 3 The incidence of cancer is not yet clear. 4 The difficulties encountered forced to adopt the principle of extensive resection. This article explores the parameters for determining the treatment protocol, describes the surgical resection, and attempts to determine the proper approach for indications and surgical resection of the tumor. During the period from 1976 to 1987, 24 cases of hepatic adenomas were diagnosed in Paul Brousse Hospital in Paris, aged 4 to 45 years. This article reviews the patient’s clinical records. The morphology of intrahepatic tumors was described using Couinaud anatomy. Twenty patients underwent peritoneal mesenteric angiography and hepatic ultrasound scans to determine the tumor’s vascular relationship.