关键词: 肝细胞癌, 肝硬化, 肝切除术, 第一肝门、半肝血流阻断, 肝静脉

Abstract: Objective To investigate the significance of 3 different hepatic blood flow occlusion techniques in the treatment of primary liver cancer complicated with liver cirrhosis.Methods Clinical data of 218 primary liver cancer patients accompanied with liver cirrhosis who received hepatectomy from March 2015 to March 2016 in our hospital was retrospectively analyzed. Among these patients, Pringle maneuver was performed in 77 cases (group A), hemihepatic blood flow occlusion was performed in 76 cases (group B) and hemihepatic blood flow occlusion and selective hepatic vein control was performed in 65 cases (group C). Operation time, bleeding, postoperative liver function and postoperative complications were compared among the 3 groups.Results Among the 3 groups, operation time of hepatectomy showed no significant differences (152±18 min vs.163±21 min vs. 172±23 min) (P>0.05), while mean intraoperative blood losses (495±76 mL vs.397±64 mL vs.317±65 mL) were significantly different (P<0.01). At day 2 and 5 after operation, serum alanine aminotransferase, total bilirubin and prealbumin levels in group A were significantly higher than those in group B and C (both P<0.01).Conclusion Hemihepatic blood occlusion can prevent systemic hepatic ischemia-reperfusion injury. Selective extrahepatic control of the hepatic vein can significantly reduce bleeding during hepatectomy.

Key words: Primary liver cancer, Liver cirrhosis, Hepatectomy, First Hepatic Portal, Hemihepatic vascular occlusion, Hepatic vein