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目的 探索全尾叶肝切除的安全方法 ,为尾叶肿瘤的治疗提供可靠途径。方法 1997年 3月至 2 0 0 0年 9月因尾状叶肿瘤行全尾叶切除 14例 ,其中 9例采用前径路法联合逆行肝切除和血管外科技术行全尾叶切除 (甲组 ) ,5例采用传统方法行全尾叶切除 (乙组 ) ,比较两种方法的手术所需时间、术中估计出血量、术后并发症、术后肝功能恢复时间及随访结果。结果 甲组手术时间短于乙组 (P <0 0 5 )、术中出血量少于乙组 (P <0 0 1)、并发症少于乙组 (P <0 0 5 )、术后肝功能恢复比乙组快 (P <0 0 1) ,随访结果优于乙组。结论 前径路法联合逆行肝切除及血管外科技术行全尾叶肝切除是安全可靠的 ,适合为尾状叶肝肿瘤行全尾叶肝切除。
Objective To explore the safe method of total caudate lobe resection and provide a reliable way for the treatment of caudate lobe tumors. Methods From March 1997 to September 2000, 14 cases of caudate lobe tumors were treated by total caudate lobe tumor resection. 9 cases were treated by anterior approach combined with retrograde hepatectomy and vascular surgery to perform total caudate lobe resection (group A) , 5 cases were treated by the traditional method of total caudate lobe resection (group B), the time required for the two methods were compared, the intraoperative blood loss, postoperative complications, postoperative liver function recovery time and follow-up results. Results The operation time of group A was shorter than group B (P <0.05), the amount of bleeding during operation was less than that of group B (P <0.01), the complication was less than that of group B (P <0 05) The functional recovery was faster than that of group B (P <0.01). The follow-up result was better than that of group B. Conclusions The anterior approach combined with retrograde hepatectomy and vascular surgery is feasible and safe. It is suitable for caudate lobe liver tumor with whole tail leaflet hepatectomy.