巨块型肝癌体积较大,其周围组织和重要管道常受到压迫甚至被侵犯,手术切除一直以来是肝脏外科的难题之一.而尾状叶巨大肿瘤因其特殊的位置和复杂的解剖结构,让众多肝脏外科医师望而却步.近年来随着手术技术不断改进,尤其是精准肝脏外科理念的提出,肝脏外科医师开始使用不同手术方式挑战尾状叶巨大肿瘤的切除.2014年4月安徽省立医院对1例58岁男性肝尾状叶巨大肿瘤患者,运用精准肝切除治疗肝癌关键技术,在未阻断入肝血流的情况下,成功施行了精准右半肝联合尾状叶肿瘤切除术,取得了良好疗效.
Hepatectomy for huge hepatocellular carcinoma (HCC) is difficult due to its huge size and the compression and invasion to the surrounding tissues as well as the important vascular systems.Surgical resection of huge carcinoma in the caudate lobe is a big challenge for hepatobiliary surgeons because of its special location and complex anatomical structure.As the improvement of surgical techniques in recent years,especially the promotion of the concept of precision liver surgery,many surgeons begin to take the challenge of resection of huge HCC in the caudate lobe in a variety of ways.In April 2014,a male patient aged 58 years with huge HCC in the caudate lobe was admitted to the Anhui Provincial Hospital.Precision right hemihepatectomy combined with caudate lobectomy was performed on this patient without occlusion of the hepatic inflow,and the efficacy was satisfactory.The key techniques involved in this procedure were discussed in this article.