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由于肝组织结构的特殊性和丰富的血循环特点,任何一种切肝法都面临着大出血的危险性.特别是右侧巨大肝癌,靠近第二肝门,极易浸润右肝静脉,下腔静脉,肝中静脉等,位置深在,可供分离的膈下肝上间隙狭窄.癌肿体积巨大,影响手术野的显露,用力不当还可撕破肝后下腔静脉及属支,导致难以控制的大出血,直接影响手术的进行,甚至威胁生命,为此,近5年来.我们分析各种切肝法的优点,适时阻断肝血流,加强局部创面止血等多种措施,联合应用切肝,成功地切除右侧巨大肝癌17例,现将临床体会报告如下.1 临床资料1990年4月～1995年9月,我们应用综合切肝技术,先后切除右侧巨块型肝癌(直径10cm以上)17例.其中男性15例,女性2例,年龄34～56岁,癌
Because of the special structure of the liver tissue and the rich blood circulation characteristics, any liver cutting method is faced with the risk of major bleeding. In particular, the large right liver cancer, close to the second liver, easily infiltrate the right hepatic vein, the inferior vena cava , Liver veins, etc., deep in position, available for separation of the subphrenic space above the stenosis. Massive cancer, affecting the surgical field exposure, improper force can also tear the posterior inferior vena cava and branch, resulting in difficult to control The hemorrhage has a direct impact on the progress of surgery and even life threatening. For this reason, in the past 5 years, we have analyzed the advantages of various methods of liver resection, timely blocking blood flow in the liver, and strengthening measures such as hemostasis on local wounds. Successfully resected 17 cases of large right hepatocellular carcinoma, and now report the clinical experience as follows.1 Clinical data From April 1990 to September 1995, we applied integrated hepatectomy technique to remove the right massive hepatocellular carcinoma (diameter 10cm or more). 17 cases, including 15 males and 2 females, aged 34 to 56 years, cancer