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位于肝门区的肿瘤,由于其瘤体邻近出入肝脏的大血管,采用常规方法进行切除是极为困难的,手术的主要危险是难以控制的大血管破裂出血。采用全肝血液转流及冷灌注下的半离体肝脏切除术成功地切除了1例侵及右肝静脉与中肝静脉汇入下腔静脉处及肝后膛静脉的巨块型肿瘤。此例病人伴有轻度肝炎后肝硬变,但肝脏功能储备良好。病人的术后病程不平稳,发生急性肝功能障碍。初步经验提示,全肝血液转流及冷灌注下的离体肝切除术可应用于伴早期肝硬变的肝癌病人。
Tumor located in the porta hepatis is extremely difficult to remove by conventional methods because it is adjacent to the large blood vessels that enter and exit the liver. The major risk of surgery is the bleeding of large vessels that are difficult to control. Hemectomy with hepatic hepatic and cold perfusion was used to successfully remove a massive tumor that invaded the right hepatic vein and the middle hepatic vein and the inferior vena cava. This patient had cirrhosis after mild hepatitis but had good liver function reserve. The postoperative course of the patient is not stable and acute liver dysfunction occurs. Preliminary experience suggests that ex vivo hepatectomy under total hepatic blood flow and cold perfusion can be applied to liver cancer patients with early cirrhosis.