【2017年整理】保留尾状叶肝次全切除术.ppt

保留尾状叶肝次全切除术(Caudate lobe-sparing subtotal hepatectomy);1、Dong J,?Lau WY,?Lu W,?Zhang W,?Wang J,?Ji W. Caudate lobe-sparing subtotal hepatectomy for primary hepatolithiasis. Br J Surg.?2012 Oct; 99(10): 1423-8. doi: 10.1002/bjs.8888.;Introduction and Methods;肝胆管结石的处理;肝胆管结石部分肝切除术的指征;肝胆管结石处理流程;保留尾叶肝次全切除术的严格指征;术前影像评估;手术操作;手术操作;Results;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;术中发现;Fig.3 Operative photographs taken after caudate lobe-sparing subtotal hepatectomy: a raw surface of hypertrophied caudate lobe; b resected right and left livers.;术后情况;Discussion;Discussion;2、彭创, 李佳, 易为民, 等. 单独保留肝尾状叶解剖性肝切除治疗肝胆管结石病. 中华消化外科杂志, 2016, 15(1): 81-84.;患者资料;图1 CT检查结果示萎缩肝脏内有较多结石。图2 CT血管造影检查结果示门静脉主干、尾叶分支、肝右后下静脉增粗，门静脉右支闭锁。;术前评估;手术方法;手术方法- 3、单独保留肝尾状叶解剖性肝切除术;图4 肝右静脉残端(→)，肝左静脉与肝中静脉共干的断端(↓)。 图5 保留的肝尾状叶。图6 肿瘤标本。图7 单独保留肝尾状叶解剖性肝切除术后示意图。Ａ：肝Ⅰ、Ⅸ段；Ｂ：胆总管；Ｃ：门静脉；Ｄ：肝左动脉；Ｅ：下腔静脉；Ｆ：右肝；Ｇ：左肝；Ｈ：十二指肠。;术中/术后情况;图8 病理学检查结果示灶状胆管上皮乳头状增生伴轻、中度非典型增生，未见癌变；HE染色、低倍放大。图9 术后11个月复查CT结果示肝内外胆管未见结石。;讨论;3、Aijun L,?Jiamei Y,?Qinhe T,?Mengchao W. Caudate?lobe?as the?sole?remnant?liver?following?extended?liver resection?for?hepatocellular carcinoma. Int J Surg Case Rep.?2014; 5(8): 462-4. doi: 10.1016/j.ijscr.2014.05.003. Epub 2014 May 14.;Introduction;Presentation of case-术前评估 ;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Presentation of case-术中情况;Presentation of case-术中情况;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Presentation of case-术后情况;Discussion;Discussion;4、仇公才, 郑万仁, 李志鹏, 等. 肝尾状叶代偿功能的研究. 中华实验外科杂志, 2014, 31(10): 2151-2154.;Introduction;Results;Results;Results;Discussion;肝尾状叶的解剖及病理(mainly from 刘允怡 and 黄志强);Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copy