肝胆胰外科新理念与新技术

发布时间：2018-08-28 09:20

【摘要】：外科手术是治疗肝胆胰肿瘤最有效和首选的方法,减少手术出血量、提高手术安全性、简化手术操作、降低并发症和死亡率,一直是肝胆胰外科领域研究的焦点.作为国内最早施行肝胆胰手术的中心之一,从20世纪80年代至今本课题组先后提出了一些新的理念:提出大肝癌和巨大肝癌手术切除的可行性理论并应用于临床,拓展了肝切除治疗肝癌的适应证;提出肝细胞癌新的分类方法,有利于针对大小不同的肿瘤选择不同的治疗方法和进行疗效评估;针对肝癌合并门静脉癌栓的不同类型,采取不同的手术方式,取得良好效果;肝切除联合脾切除治疗原发性肝细胞癌合并门静脉高压症.创立3种肝脏手术控制出血新技术:不解剖肝门经肝实质结扎入肝及出肝血流、第一肝门阻断联合肝下下腔静脉阻断、经肝裸区双悬吊法;小范围肝切除治疗肝门部胆管癌的新理念;不缝合胆管前壁的肝肠吻合术和插入式胆肠吻合术;新的"U"型胰肠套入式缝合法;世界首个原位辅助性部分肝移植手术方式,并成功应用于临床.
[Abstract]:Surgery is the most effective and first choice method in the treatment of hepatobiliary and pancreatic tumors. It has been the focus in the field of hepatobiliary and pancreatic surgery to reduce the amount of operative bleeding, improve the safety of the operation, simplify the operation, and reduce the complications and mortality. As one of the earliest centers of hepatobiliary and pancreatic surgery in China, since the 1980s, our group has put forward some new ideas: to put forward the feasible theory of surgical resection of large liver cancer and giant liver cancer and to apply it to clinical practice. Expanding the indication of hepatectomy for liver cancer, proposing a new classification method of hepatocellular carcinoma, which is helpful to select different treatment methods and evaluate the curative effect for tumor of different size and size, and aiming at different types of hepatocellular carcinoma with portal vein tumor thrombus. Hepatectomy combined with splenectomy was used to treat primary hepatocellular carcinoma with portal hypertension. Three new techniques were established to control bleeding in liver surgery: no dissection of hepatic portal ligation through hepatic parenchyma into and out of liver blood flow, the first hepatic portal occlusion combined with inferior hepatic vena cava occlusion, and double suspension through the bare liver area; A new concept of small-scale hepatectomy in the treatment of hilar cholangiocarcinoma; hepatoenterostomy without suture of the anterior wall of the bile duct and inserted cholangiojejunostomy; a new "U" type pancreaticojejunostomy; the world's first orthotopic auxiliary partial liver transplantation, And successfully applied in clinic.
【作者单位】：华中科技大学同济医学院附属同济医院肝脏外科中心湖北省肝脏外科医学临床研究中心教育部器官移植重点实验室卫生部器官移植重点实验室;
【基金】：国家科技重大专项(2012ZX10002016-004,2012ZX10002010-001-004)资助
【分类号】：R656

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