中文摘要：

目的 探讨肝尾状叶良性肿瘤的手术疗效.方法 回顾性分析2003年1月至2014年4月第二军医大学附属东方肝胆外科医院收治的1 12例肝尾状叶良性肿瘤患者的临床资料.根据肿瘤部位、大小等选择采用左侧入路、右侧入路、双侧入路、中央前入路或逆行肝尾状叶切除术.采用门诊或电话方式进行随访,随访时间截至2014年10月.结果 112例患者均具有手术治疗的适应证,均完整切除肿瘤,其中行单纯肝尾状叶肿瘤切除术33例（22例双侧入路、11例左侧入路）,左半肝＋尾状叶切除术28例（左侧入路）,肝中叶＋尾状叶切除术21例（中央前入路）,部分肝右叶＋尾状叶切除术19例（右侧入路）,右半肝＋尾状叶切除术11例（9例右侧入路、2例逆行切除）.术中单纯入肝血流阻断72例,入肝血流联合肝静脉阻断29例,全肝血流阻断6例,未行肝血流阻断5例.手术时间为（192±69） min,平均入肝血流阻断时间为28 min（0 -94 min）,平均术中出血量为590 mL（100- 12 000 mL）,术中输血例数为68例,平均输血量为600 mL（200 - 10 000 mL）,术后住院时间为（8.2±2.7）d.31例患者术后发生并发症,其中胆汁漏21例,中等量以上胸腔积液7例,术后出血2例,均经对症处理后痊愈;肝衰竭1例,经保肝治疗后好转.无围术期死亡患者.112例患者均获得术后随访,中位随访时间为12个月（6-24个月）.随访期间,112例患者均健康生存,无一例患者肿瘤复发或因手术相关并发症死亡.结论 手术切除是治疗肝尾状叶良性肿瘤的有效手段,患者术后恢复良好,手术疗效确切.严格把握手术适应证,合理优化手术路径,术中采用选择性肝血流阻断,精细操作是手术成功的关键.

英文摘要：

Objective To evaluate the surgical efficacy of benign tumor of liver in the caudate lobe.Methods The clinical data of 112 patients with benign tumor of liver in the caudate lobe who were admitted to the Eastern Hepatobiliary Surgery Hospital from January 2003 to April 2014 were retrospectively analyzed.The leftsided approach,right-sided approach,bilateral approach,central anterior approach and retrograde caudate lobectomy were selected according to the location and size of the tumor.All the patients were followed up by outpatient examination and telephone interview up to October 2014.Results Of all the 112 patients who received complete resection of tumor,33 patients received caudate lobectomy （22 by bilateral approach,11 by left-sided approach）,28 received left hemihepatectomy ＋ caudate lobectomy （by left-sided approach）,21 received mesohepatectomy ＋ caudate lobectomy （by central anterior approach）,19 received partial right hepatectomy ＋ caudate lobectomy （by right-sided approach）,11 received right hemihepatectomy ＋ candate lobectomy （9 by right-sided approach,2 by retrograde caudate lobectomy）.During the operation,72 patients received vascular inflow occlusion,29 received vascular inflow occlusion combined with hepatic veins occlusion,6 received total hepatic vascular exclusion and 5 did not receive vascular inflow occlusion.The operation time,mean time of vascular inflow occlusion,mean volume of intraoperative blood loss,cases of blood transfusion,mean volume of blood transfusion and duration of postoperative hospital stay were （192 ± 69）minutes,28 minutes （range,0-94 minutes）,590 mL （range,100-12 000 mL）,68,600 mL （range,200-10 000mL） and （8.2 ± 2.7） days,respectively.Thirty-one patients had postoperative complications,including 21 with bile leakage,7 with medium and above volume of pleural effusion,2 with postoperative bleeding and 1 with hepatic failure.The complications were cured after symptomatic treatment.No patient died perioperatively.All the 112 patie