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目的:探讨安全切除紧贴肝门区的巨大肝海绵状血管瘤的方法。方法:回顾性分析2008年4月—2012年3月手术治疗的35例紧贴肝门区的巨大肝海绵状血管瘤患者的临床资料。结果:全组术中失血量100~7 000 mL。根据瘤体位置及大小选择不同肝血流阻断方法和切除术式,其中,Pringle法11例,改良Pringle法9例,半肝血流阻断法15例;血管瘤包膜外剥除24例,肝切除10例,缝扎1例。术后18例出现相关并发症,无手术死亡。结论:肝门区巨大肝海绵状血管瘤手术的关键在于控制和处理出血,尽可能保留足够量的正常肝组织,应用合理的入肝血流阻断方法和切除手段是安全可行的。
Objective: To explore the method of safely removing the huge hepatic cavernous hemangioma close to the hilar region. Methods: The clinical data of 35 patients with giant hepatic cavernous hemangioma close to the hilar region were retrospectively analyzed from April 2008 to March 2012. Results: The blood loss of the whole group was 100-7 000 mL. According to the location and size of the tumor, different methods of hepatic blood flow occlusion and resection were selected. Among them, 11 cases were Pringle method, 9 cases were modified Pringle method and 15 cases were hemifloxia occlusion method. Cases, liver resection in 10 cases, suture in 1 case. Postoperative complications occurred in 18 cases, no surgical death. CONCLUSION: The key to the surgical treatment of giant hepatic cavernous hemangiomas in the hilar region is to control and treat the hemorrhage. It is safe and feasible to use a reasonable method of hepatic blood flow blocking and resection as far as possible to retain a sufficient amount of normal liver tissue.