文章摘要

右侧入路联合反向染色法处理肝尾状叶肝癌破裂出血1例并文献复习

作者: 1陈海敏, 2刘贵疆, 1袁荣发, 1方路, 1梁博, 1吴鹏, 1王超
1 南昌大学第二附属医院 肝胆胰外科，江西 南昌 330006
2 江西省永修县人民医院 普通外科，江西 永修 330300
通讯: 方路 Email: fanglu@medmail.com.cn
DOI: 10.3978/.10.3978/j.issn.1005-6947.2017.02.015
基金: 国家自然科学基金资助项目, 81560396 江西省卫生厅科技计划基金资助项目, 20131077 江西省教育厅科学技术基金资助项目, GJJ150260

摘要

目的：探讨单纯经右侧入路联合反向染色法完整切除肝尾状叶肝癌破裂出血的安全性及可行性。方法：回顾性分析1例肝尾状叶肝癌伴破裂出血患者的临床资料并复习相关文献。结果：术前对患者的肝功能及肿瘤情况进行严密评估，排除手术禁忌证后，患者成功行右侧入路联合反向染色法（对肝右后叶染色区分尾状叶的右侧边界）完整切除肝尾状叶，术中未阻断入肝血流、出肝血流、下腔静脉，术后患者肝功能恢复良好。术后6个月复查，未见肿瘤复发。结论：单纯行右侧入路联合反向染色法完整切除肝尾状叶肿瘤破裂出血是安全可行的。
关键词： 癌，肝细胞 破裂，自发性 肝切除术 尾状叶

Treatment of spontaneous rupture of hepatocellular carcinoma in hepatic caudate lobe via right-side approach combined with reverse staining: a report of one case with literature review

Authors: 1CHEN CHEN Haimin, 2LIU Guijiang, 1YUAN Rongfa, 1FANG Lu, 1LIANG Bo, 1WU Peng, 1WANG Chao
1 Department of Hepatobiliary Surgery, the Second Affiliated Hospital, Nanchang University, Nanchang 330006, China
2 Department of General Surgery, Yongxiu People’s Hospital, Yongxiu, Jiangxi 330300, China

CorrespondingAuthor:FANG Lu Email: fanglu@medmail.com.cn

Abstract

Objective: To investigate the safety and feasibility of complete resection of the hepatic caudate lobe with ruptured hepatocellular carcinoma (HCC) via right-side approach combined with reverse staining. Methods: The clinical data of one patient with spontaneous rupture of caudate lobe HCC was retrospectively analysed and combined with relevant literature review. Results: The liver function and tumor characteristics of the patient were rigorously evaluated before operation. After exclusion of contraindications for surgery, complete resection of the caudate lobe of the patient was successfully performed via right-side approach combined with reverse staining (distinguishing the border of the caudate lobe by dyeing the posterior right hepatic lobe). No occlusion of hepatic inflow and outflow or inferior vena cava was performed during operation. Liver function of the patient recovered well after operation. No recurrence was noted in a review visit 6 months after operation. Conclusion: Complete resection of caudate lobe with spontaneous rupture of HCC via simple right-side approach combined with reverse staining is safe and feasible.
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