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肝脏海绵状血管瘤的最好治疗方法是手术切除，但对已侵犯肝门的血管瘤手术风险较大，肛门的处理是手术的最大难题。我科自94年2月至97年2月共收治21例紧贴一、二、三肝门的巨大血管瘤，瘤体最大径线12～36cm，平均24cm。术中先结扎患侧肝动脉，然后再解剖分离肝门，在第一肝门阻断下全部完整切除了瘤体，行肝右三叶及尾状叶切除5例，右半肝及尾状叶切除7例，右半肝切除1例，右肝上段切除3例。右后叶切除2例，左三叶及尾状叶切除3例。术后无并发症，全部恢复良好。本文着重讨论了瘤体切除时肝门的操作步骤及其注意点，特别在此手术成功的关键，肝短静脉及肝静脉的操作方面进行了讨论。全部病例皆未行全肝血流阻断，较好地避免了可能由于阻断带来的并发症。
The best treatment for hepatic cavernous hemangiomas is surgical resection. However, the surgical risk for hemangiomas that have violated hepatic hilum is relatively high. The treatment of the anus is the biggest problem for surgery. In our department from February 1994 to February 1997, a total of 21 cases of giant hemangiomas that closely adhered to the primary, secondary, and tertiary portals were treated. The maximum diameter of the tumor was 12 to 36 cm, with an average of 24 cm. The affected hepatic artery was ligated first, and then the hilar was dissected and completely removed under the first hilar obstruction. The right hepatic tricuspid and caudate lobe resection was performed in 5 cases. The right hemi liver and caudate shape were obtained. There were 7 cases of lobectomy, 1 case of right hemihepatectomy, and 3 cases of right hepatectomy. Right posterior lobe resection was performed in 2 patients, and left tricuspidectomy and caudate lobe resection were performed in 3 patients. No complications occurred after surgery and all recovered well. This article focuses on the operation steps of the hepatic hilus and its points of attention during the resection of the tumor. In particular, the key to successful operation, the operation of the short hepatic veins and hepatic veins are discussed. In all cases, hepatic blood flow was not blocked, and complications that may be caused by the blockade were better avoided.