【摘要】 目的总结肝切除术中肝创面的处理经验。方法回顾性分析121例肝切除,其中,大网膜直接覆盖法18例,基底大网膜填塞+对拢缝合法25例,单纯对拢缝合法62例,医用生物胶喷涂+止血纱布覆盖法16例。结果术后腹腔引流血量分别为434±269ml、305±194ml、288±175ml、359±217ml。术后因出血再次手术1例,因出血及肝创面血肿保守治愈1例,胆漏4例,肝周感染7例,死亡3例。结论对拢缝合法适用于局部肝切除以及左肝切除。而医用生物胶喷涂+止血纱布覆盖法适用于肝创面较大的右肝切除及难以对拢缝合的肝切除,尤为适合贴近下腔静脉的肝切除。更多还原

【Abstract】 Objective To summarize the experience of manegement of hepatic cutting surface in hepatectomy.Methods 121 cases of management of hepatic cutting surface in hepatectomy were analyzed retrospectively,among which 18 were directly covered by greater omentum,25 were wadded at the basement by greater omentum,adding stitching,62 were purely stitched,16 were coated by medical glue and hemostatic gauze.Result Postoperative bleeding in abdominal drainage were respectively for 434±269ml?305±194ml?288±175ml?359±217ml.One patient undergoed reoperation because of haemorrahage,1 conservative treatment because of haemorrahage and hematoma of the liver’s cutting surgface,4 bile leakage,7 perihepatitis,3 death.Conclusion Sitiching is adequate for partial hepatectomy and left hepatectomy,moreover the medical glue plus hemostatic gauze for right hepatectomy and that hard for stitching,especially the one that close to postcava.更多还原