ObjectiveTo explore it's advantages and disadvantages through analyzed the data of associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) operation in 3 cases of liver cancer patients with cirrhosis. MethodsThe data of 3 patients perfomed ALPPS operation were retrospectively analyzed, through the preoperative evaluation, intraoperative and postoperative treatment points analyzed to explore the pros and cons. ResultsOne case died of hepatic failure, and the remaining two cases were still alive. The highest score of MELD of liver failure in death case was 18.8 scores, and the other cases of MELD score were decreased after second operation. The average increased volume of liver was 225 mL, and the liver volume was significantly increased (P=0.002). ConclusionsALPPS make a portion of huge liver cancer patients combining with cirrhosis having a chance to surgery. But it is necessary to consider in patients with preoperative state, surgical risk, prognosis and economic conditions,in order to determine whether patients can benefit from ALPPS.
目的 探讨应用带蒂大网膜治疗严重肝创伤的方法。方法回顾性地对1986~1999年收治的严重肝创伤应用带蒂大网膜填塞覆盖缝合术91例的临床资料进行分析。结果 治愈81例(89.0%),死亡10例(11.0%)。术后近期出血、胆汁渗出4例(4.4%),胆漏3例(3.3%),膈下脓肿5例(5.5%)。结论 带蒂大网膜在救治严重肝创伤中有着重要的作用,对肝创面彻底清创、止血、妥善缝扎创口和胆管等是应用带蒂大网膜缝合术的先决条件。