Resecting of Eight Patients with Caudate Lobe of Liver Cavernous Hemangioma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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刘驰 , 万春

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肝尾状叶; 海绵状血管瘤; 手术

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目的总结肝尾状叶海绵状血管瘤手术切除的指征及技巧。方法对我科2005年9月至2010年9月期间开展的8例肝尾状叶海绵状血管瘤切除病例的临床资料进行分析。结果全组患者均在无血流阻断下顺利完成手术，无手术死亡。术中出血量为1 000～5 000 ml，（2 500±800） ml; 手术时间为3～6 h，(4.2±0.8） h。1例肝硬变患者术后1 d即出现腹水，经积极治疗后得以控制。3例患者术后1周发现右侧胸腔积液，经1～2次胸腔穿刺抽液后治愈。1例患者术后1周出现不全性肠梗阻，经保守治疗1周后痊愈。术后应用B超每半年复查肝脏情况，随访0.5～5年，（2.5±1.2）年，1例失访，1例患者死于心肌梗死，余均存活，仍在随访中。所有病例均未复发。结论肝尾状叶海绵状血管瘤手术应充分显露、精准操作，彻底切除肿瘤，避免大出血和空气栓塞，减少和防止残肝的热缺血再灌注损伤。

Citation： 刘驰,万春. Resecting of Eight Patients with Caudate Lobe of Liver Cavernous Hemangioma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(9): 1001-1002. doi: Copy

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6.	Miyayama S, Matsui O, Taki K, et al. Arterial blood supply to the posterior aspect of segment Ⅳ of the liver from the caudate branch: demonstration at CT after iodized oil injection [J]. Radiology, 2005, 237(3): 11101114.
7.	Hinshaw JL, Laeseke PJ, Weber SM, et al. Multipleelectrode radiofrequency ablationof symptomatic hepatic cavernous hemangioma [J]. AJR Am J Roentgenol, 2007, 189(3): W146W149.
8.	赵英鹏, 李晓延, 范蜀滨, 等. 肝血管瘤手术切除血流阻断方法的选择 [J]. 中国普外基础与临床杂志, 2011, 18(1): 8183.
9.	Popescu I, Ciurea S, Romanescu D, et al. Isolated resection of the caudate lobe: indications, technique and results [J]. Hepatogastroenterology, 2008, 55(84): 831835.
10.	Gibbs JF, Litwin AM, Kahlenberg MS. Contemporary management of benign liver tumors [J]. Surg Clin North Am, 2004, 84(2): 463480.
11.	Farges O, Daradkeh S, Bismuth H. Cavernous hemangiomas of the liver: are there any indications for resection? [J]. World J Surg, 1995, 19(1): 1924.
12.	Sood D, Kumaran V, Buxi TB, et al. Liver hemangioma mimicking cholangiocarcinoma—a diagnostic dilemma [J]. Trop Gastroenterol, 2009, 30(1): 4446.
13.	Hu JX, Miao XY, Zhong DW, et al. Anterior approach for complete isolated caudate lobectomy [J]. Hepatogastroenterology, 2005, 52(66): 16411644.
14.	Chaib E, Ribeiro MA, Silva Fde S, et al. Surgical approach for hepatic caudate lobectomy: Review of 401 cases [J]. J Am Coll Surg, 2007, 204(1): 118127.
15.	徐锋, 戴朝六, 贾昌俊, 等. 肝尾状叶及右前叶巨大血管瘤手术切除1例 [J]. 中华肿瘤防治杂志, 2007, 14(4): 319320.
16.	欧琨, 邢雪, 陈强谱, 等. 肝巨大肿瘤切除及其方法探讨: 附18例报告 [J]. 中国普通外科杂志, 2006, 15(7): 553555.

1. 杨志明. 肝尾状叶巨大海绵状血管瘤的外科处理 [J]. 中国普外临床与基础杂志, 2008, 15(4): 295296.
2. Matusz PL, Pusztai AM, Hordovan EC, et al. The venous drainage of the caudatelobe. Study on corrosion casts [J]. FASEB J, 2010, 24(Meeting Abstract Supplement) lb6.
3. 侯东生, 钟世镇, 丁自海, 等. 尾状叶切除术应用解剖学研究 [J]. 中国临床解剖学杂志, 2006, 24(6): 612615.
4. 黄志强, 周宁新, 黄晓强, 等. 尾状叶外科—肝外科的最后领域 [J]. 消化外科杂志, 2004, 3(1): 117.
5. 戴朝六. 肝脏巨大尾状叶肿瘤切除术应注意的几个问题 [J/OL]. 中华普通外科学文献（电子版）, 2010, 4(1): 36.
6. Miyayama S, Matsui O, Taki K, et al. Arterial blood supply to the posterior aspect of segment Ⅳ of the liver from the caudate branch: demonstration at CT after iodized oil injection [J]. Radiology, 2005, 237(3): 11101114.
7. Hinshaw JL, Laeseke PJ, Weber SM, et al. Multipleelectrode radiofrequency ablationof symptomatic hepatic cavernous hemangioma [J]. AJR Am J Roentgenol, 2007, 189(3): W146W149.
8. 赵英鹏, 李晓延, 范蜀滨, 等. 肝血管瘤手术切除血流阻断方法的选择 [J]. 中国普外基础与临床杂志, 2011, 18(1): 8183.
9. Popescu I, Ciurea S, Romanescu D, et al. Isolated resection of the caudate lobe: indications, technique and results [J]. Hepatogastroenterology, 2008, 55(84): 831835.
10. Gibbs JF, Litwin AM, Kahlenberg MS. Contemporary management of benign liver tumors [J]. Surg Clin North Am, 2004, 84(2): 463480.
11. Farges O, Daradkeh S, Bismuth H. Cavernous hemangiomas of the liver: are there any indications for resection? [J]. World J Surg, 1995, 19(1): 1924.
12. Sood D, Kumaran V, Buxi TB, et al. Liver hemangioma mimicking cholangiocarcinoma—a diagnostic dilemma [J]. Trop Gastroenterol, 2009, 30(1): 4446.
13. Hu JX, Miao XY, Zhong DW, et al. Anterior approach for complete isolated caudate lobectomy [J]. Hepatogastroenterology, 2005, 52(66): 16411644.
14. Chaib E, Ribeiro MA, Silva Fde S, et al. Surgical approach for hepatic caudate lobectomy: Review of 401 cases [J]. J Am Coll Surg, 2007, 204(1): 118127.
15. 徐锋, 戴朝六, 贾昌俊, 等. 肝尾状叶及右前叶巨大血管瘤手术切除1例 [J]. 中华肿瘤防治杂志, 2007, 14(4): 319320.
16. 欧琨, 邢雪, 陈强谱, 等. 肝巨大肿瘤切除及其方法探讨: 附18例报告 [J]. 中国普通外科杂志, 2006, 15(7): 553555.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Resecting of Eight Patients with Caudate Lobe of Liver Cavernous Hemangioma

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