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目的累及第二第三肝门的巨大肝癌往往被视为不可切除,本文探讨其可切除性及手术的安全性。方法 25例累及第二第三肝门的肝癌,平均肿瘤直径14.78cm,分别压迫主要肝静脉根部或/和肝后腔静脉;进腹充分暴露肿瘤后在间歇性第一肝门阻断下切除肿瘤,切肝前根据需要预置腔静脉阻断带备用。结果 25例肝癌均得到顺利切除,无手术死亡及严重并发症发生;平均手术时间205min,平均出血量1508ml;随访半年生存率87.23%,半年肿瘤复发率20%。结论切除累及第二第三肝门的巨大肝癌虽具一定挑战性,但只要方法得当仍然是可行和安全的手术。
The purpose of the huge involvement of the second hepatic portal hepatocellular carcinoma is often considered unresectable, this article discusses its resectability and surgical safety. Methods Twenty-five patients with HCC involving the second third hepatic hilar had an average tumor diameter of 14.78 cm, respectively, which were pressed to the root of the main hepatic vein or / and the posterior hepatic veins. After sufficient exposure to the tumor, the tumor was resected under intermittent first hepatic hilar obstruction Tumor, pre-hepatectomy, according to the need to preset the vena cava block with spare. Results All the 25 cases of HCC were successfully resected without any operative death and serious complications. The average operation time was 205 minutes and the average amount of bleeding was 1508ml. The follow-up half-year survival rate was 87.23% and the recurrence rate was 20% in half a year. Conclusions Excision of giant hepatocellular carcinoma involving the second third hepatic portal may be challenging, but surgery is still feasible and safe as long as the method is appropriate.