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首页> 外文期刊>Journal of hepato-biliary-pancreatic surgery >Right hepatectomies without vascular clamping: report of 87 cases.
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Right hepatectomies without vascular clamping: report of 87 cases.

机译：右肝切除术无血管夹闭：附87例报告。

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Background/Purpose. Portal triad clamping and total or intermittent hepatic vascular exclusion are usually used to reduce blood loss during major liver resections. We report, in this retrospective study, the results of right hepatectomy without vascular clamping. Methods. From January 1986 to July 2001, 87 right hepatectomies, including 14 extended right hepatectomies, were performed without vascular clamping. There was 53 men and 34 women, with a mean age of 60.2 +/- 12.5 years. Indications were 58 metastases, 16 hepatocellular carcinomas, 5 cholangiocarcinomas, 4 adenomas, 3 angiomas, and 1 carcinoid tumor. All the procedures were carried out using an ultrasonic dissector and intraoperative ultrasonography with only vascular control (looping of the hepatic pedicle and supra; and infrahepatic vena cava). Results. There were four postoperative deaths and 23 complications (26%), including hepatocellular failure (6), pulmonary complications (6), transient bile leakage (5), digestive bleeding (2), subphrenic abscess (1), inferior vena cava (IVC) thrombosis (1), disseminated intravascular coagulation (DIC; 1), and evisceration (1). Forty-two patients (48%) had no blood transfusion. The mean blood transfusion requirement was 1.5 +/- 2.7 units. The mean operative length was 280 +/- 60 min and the mean hospital stay was 12.8 +/- 8.1 days. Liver function test results were similar to those in other studies on days 1, 4, and 7 postoperatively, with a return to normal values after 1 week. Conclusions. In our experience with major liver resections, vascular clamping is not necessary.
机译：背景/目的。门静脉三联症钳夹和完全或间歇性肝血管排斥通常用于减少大面积肝切除术中的失血量。我们在这项回顾性研究中报告了不进行血管夹持的右肝切除术的结果。方法。从1986年1月至2001年7月，进行了87例右肝切除术，其中包括14例扩大的右肝切除术，没有进行血管钳夹。男53例，女34例，平均年龄60.2 +/- 12.5岁。适应症为58个转移灶，16个肝细胞癌，5个胆管癌，4个腺瘤，3个血管瘤和1个类癌。所有过程均使用超声解剖器和术中超声检查，仅进行血管控制（肝蒂和上文环行;肝下腔静脉）。结果。共有4例术后死亡和23例并发症（26％），包括肝细胞衰竭（6），肺部并发症（6），短暂性胆漏（5），消化道出血（2），phr下脓肿（1），下腔静脉（IVC） ）血栓形成（1），弥散性血管内凝血（DIC; 1）和内脏清除（1）。四十二名患者（48％）没有输血。平均输血量为1.5 +/- 2.7单位。平均手术时间为280 +/- 60分钟，平均住院时间为12.8 +/- 8.1天。肝功能检查的结果与其他研究在术后第1、4和7天的结果相似，在1周后恢复到正常值。结论。根据我们进行大型肝脏切除术的经验，不需要进行血管夹紧。

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