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目的探讨特殊部位肝海绵状血管瘤的外科治疗经验。方法对32例位于第二肝门附近和尾状叶内的肝海绵状血管瘤的临床资料进行回顾分析。结果本组病例均采用包膜外剥离术,血管瘤均获完全切除,手术死亡率3.1%(1/32),术中出血量50～10000ml,12例病人术中进行了输血,输血量400～4000ml不等。术后发生胆漏(1例)、膈下积液(1例)和右侧胸腔积液(3例)等并发症5例(发生率15.6%),26例获平均(3.09±0.93)年随访,未见血管瘤复发。结论熟悉肝脏解剖及熟练的手术技巧是手术成功的关键,包膜外剥离术是治疗肝海绵状血管瘤安全、有效的方法。
Objective To investigate the surgical treatment of hepatic cavernous hemangioma at special sites. Methods The clinical data of 32 cases of hepatic cavernous hemangioma located in the vicinity of the second hilar and caudate lobe were retrospectively analyzed. Results All the patients were treated with extracapsular dissection and hemangiomas were completely resected. The operative mortality rate was 3.1% (1/32) and the intraoperative blood loss was 50 ~ 10000ml. Twelve patients underwent transfusions and transfusions of 400 ~ 4000ml range. Postoperative complications such as bile leakage (1 case), subphrenic effusion (1 case) and right pleural effusion (3 cases) were found in 5 cases (15.6%) and 26 cases (3.09 ± 0.93) years Follow-up, no recurrence of hemangiomas. Conclusion Familiar with liver anatomy and skilled surgical techniques is the key to successful operation. Extracapsular dissection is a safe and effective method for the treatment of hepatic cavernous hemangiomas.