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本文探讨了典型性肝切除术的发展趋向。由于现代肝外科定位诊断的进展(B超、核索扫描、CT、选择性动脉造影),使得小肝癌得以早期诊断,手术可以缩小到作局部切除;由于中期肝癌在切除术后复发率仍高,手术似应扩大到全肝切除、肝移植。典型性肝切除技术也有新的改进,如低温全肝灌洗切肝法、常温全肝血流阻断切肝法、全肝隔离灌洗法等。本文还讨论了肝切除在原发性肝癌、转移性肝癌、肝胆管结石、外伤性肝破裂的具体应用范围,并对如何控制、避免典型性肝切除手术中出血问题的具体技术操作,提出了自己的看法。
This article discusses the development trend of typical hepatectomy. Due to the advancement of local liver biopsy diagnosis (B-ultrasonography, nuclear scan, CT, selective arteriography), early diagnosis of small hepatocellular carcinoma can be achieved, and surgery can be reduced to local resection; because of the high recurrence rate of metastatic liver cancer after resection Surgery should be extended to total hepatectomy and liver transplantation. Typical hepatic resection techniques also have new improvements, such as low-temperature hepatic lavage liver-cutting method, normal-temperature hepatic blood flow blocking liver-cutting method, and whole liver isolation lavage method. This article also discusses the specific application range of hepatectomy in primary liver cancer, metastatic liver cancer, hepatobiliary stones, and traumatic liver rupture, and proposes specific technical operations on how to control and avoid hemorrhage in typical hepatectomy. Your own opinion.