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我们近5年来对肝癌患者施行不同范围肝切除术15例,未发生严重并发症,无手术死亡,本文就肝癌切除手术有关问题谈几点体会。1 临床资料本组15例中男性12例,女性3例。年龄35～69岁,平均44岁。原发性肝癌13例,胃癌、直肠癌肝转移各1例。手术行右半肝切除、左半肝切除各1例,左外叶切除2例,不规则肝切除11例,2例行肝动脉插管化疗碘油栓塞,肿瘤缩小后二期切除。1例肝癌切除后余肝微小子灶切除困难,行肝动脉插管化疗。手术在常温下肝门血流阻断10例,肝门血管结扎1例,肝钳法止血2例,自制弧形针区域止血2例。术中B超检查8例,6例小肝癌触诊不明显,术中B超定位找到肿瘤;1例巨块悬垂型肝癌切除后B超提示余肝内3处肿瘤子灶。
In the past five years, we have performed 15 cases of liver cancer patients with different scope of liver resection, no serious complications, no operative death. This article on the liver cancer resection surgery problems related to a few experience. 1 clinical data in this group of 15 cases of 12 males and 3 females. Age 35 to 69 years old, average 44 years old. There were 13 cases of primary liver cancer, 1 case of gastric cancer, and 1 case of rectal cancer liver metastasis. Right hemihepatectomy and left hemihepatectomy were performed in 1 case, left lateral lobe resection in 2 cases, irregular hepatectomy in 11 cases, and 2 cases underwent hepatic artery catheter chemotherapy with lipiodol embolization. One case of liver cancer after resection of the liver subtotal difficult to remove the hepatic artery catheterization chemotherapy. At the normal temperature, 10 cases of hepatic portal vein occlusion were performed, 1 case of hepatic portal vein ligation, 2 cases of hepatic clamping to stop bleeding, and 2 cases of self-made arc needle to stop bleeding. Intraoperative B-ultrasound examination in 8 cases, 6 cases of small hepatocellular carcinoma palpation was not obvious, intraoperative B-ultrasonic positioning to find the tumor; 1 case of massive suspension-type hepatocellular carcinoma after B-ultrasound prompted three liver tumor sub-foci.