【摘要】 目的　总结刮吸断肝术在 4 4例第Ⅷ肝段切除术中应用的经验。方法　使用多功能手术解剖器 (PMOD)采取刮吸法断肝术施行第Ⅷ段肝癌切除 4 4例。仅 5例需行全肝血流控制 ,其中 2例行受累下腔静脉壁部分切除修补 ,2例行门静脉切开取栓。术中肝门阻断时间 (4 2± 2 2 )min ;出血(12 84± 875 )ml;手术切除时间是 (6 9 8± 4 4 1)min。结果　全组无手术死亡。术后无胆瘘、出血等并发症。术后 3例肝性腹水 ,4例右胸积液。均经对症处理后缓解。结论　使用PMOD采取刮吸法断肝 ,能进行精细解剖 ,把第Ⅷ段从下腔静脉和肝静脉之间分离出来 ,从而安全地切除第Ⅷ段。更多还原

【Abstract】 Objective To summarize the experience in resection of segment Ⅷ of the liver for 44 cases of carcinoma by curettage and aspiration technique. Methods Resection of segment Ⅷ of the liver was performed in 44 patients with Peng’s multifunctional operative dissector (PMOD) to transect the segment with curettage and aspiration technique. Five cases needed total hepatic vascular exclusion (THVE) and 2 had the invaded wall of the inferior vena cava resected and repaired. Two cases received the removal of tumor thrombi in the portal vein. The mean intraoperative blood loss was 1 284±875 ml, mean time of vascular occlusion of inflow 42±22 min and mean time of resection 69.8±44.1 min. Results There was no operative death. The postoperative complications were right pleural effusion in 4 cases and ascites in 3. All patients were cured by symptomatic treatment. Biliary fistula and bleeding did not occur after the operation. Conclusions Using curettage and aspiration technique, it is possible to precisely dissect the structure. Therefore, segment Ⅷ of the liver can be isolated from hepatic veins and IVC without any difficulty and the resection can be safely performed.更多还原