原发性肝癌——经典.pptVIP

A large branch of the inferior group of hepatic veins was isolated.? The large branch was ligated on the liver side, and clamped on the vena cava side.??? After division and oversewing of the branch, another large branch was revealed behind.??????? The second branch was divided in similar fashion.??? The right hepatic vein was isolated.?? The right hepatic vein was divided with a linear vascular stapler.?? Smaller short hepatic branches were divided, freeing the right anterolateral wall of the inferior vena cava.??? The right lobe was fully mobilized Umbilical tape was passed behind the liver, to mark the plane between vena cava and gallbladder bed delineating the division of right and left lob Division of the devascularized right lobe was begun anteriorly using electrocautery.??????? The plane of dissection was kept to the left of the middle hepatic vein (see hepatic segmental anatomy) because of the proximity of that structure to the tumor.?Vascular connections between segment IV and the right lobe were isolated and divided between clips.???? An argon beam coagulator was used to aid surface hemostasis.?? The partially divided interlobar plane is shown.??????? The ultrasonic dissector/aspirator was used to further develop the plane The middle hepatic vein was divided at its junction with the left hepatic vein.? The last connections of the right lobe are shown from the patients left. The connections, including the right hepatic duct, were divided and the specimen removed.??????? The abdomen is shown after removal of the specimen.? The lateral surface of the right lobe is shown (caudal to left, posterior to top).??????? The abdomen was closed in standard fashion * 八、肝癌的治疗 热凝固治疗:通过微波或射频，在肿瘤局部产生高温使肿瘤凝固变性，达到治疗肝癌或肝癌减积的目的，其适应症与冷冻治疗相同。 八、肝癌的治疗 放射治疗 化学治疗 免疫治疗 中医中药治疗 九、小结 肝癌的发病率逐年提高，有年轻化的趋势。 诊断方法、治疗方法多样。 随着原发性肝癌的早期诊断、早期治疗和肝脏外科的发展，肝癌的总体治疗效果显著提高。 以针对患者的个体化综合治疗效果较好。 A 21-year-old man presented with a 2-month history of weight loss, night sweats and early sat