肝胆胰外科杂志2025，Vol.37Issue(8)：511-515,523,6.DOI:10.11952/j.issn.1007-1954.2025.08.002
肝断面胶封法处理在中央肝切除术中的应用
Application of liver section sealing management in central hepatectomy
摘要
Abstract
Objective To compare the clinical effect of liver section sealing management and open liver section management in central hepatectomy,and to explore the clinical application value of liver section sealing management.Methods The clinical data of 56 patients who underwent central hepatectomy in the First Affiliated Hospital of Wenzhou Medical University from Jan.2020 to Dec.2024 were retrospectively analyzed.According to the different managements of liver section,patients were divided into the liver section sealing management group(n=15)and the open liver section management group(n=41).The short-term clinical outcomes and related clinical indicators between the two groups were compared.Results There were no surgical deaths,liver failure or other serious complications in either group.Two cases of pleural effusion were found in liver section sealing management group,with no case of bile leakage,cutting surface bleeding or cutting surface infection.One case of bile leakage,3 cases of pleural effusion and 2 cases of cutting surface bleeding were found in the open liver section management group,with no case of cutting surface infection.There was no significant difference in the incidence of complications between the two groups[13.33%(2/15)vs 14.63%(6/41),P=0.678].There was no statistically significant difference in terms of operation time,intraoperative blood loss,or hepatic hilum occlusion time between the two groups(P>0.05).In the liver section sealing management group,the intraperitoneal drainage volume on the 1st day[(118.67±75.77)mL vs 150.00(120.00,210.00)mL,Z=-2.124,P=0.034],the 2nd day[(107.00±38.63)mL vs 150.00(100.00,220.00)mL,Z=-2.628,P=0.009]and the 3rd day[(65.67±41.18)mL vs 130.00(80.00,220.00)mL,Z=-3.661,P<0.001]postoperatively was significantly less than those in the open liver section management group.There was no significant difference in aminotransferase(ALT),total bilirubin(TBIL)and creatinine(Cr)levels on the 1st,3rd and 7th day postoperatively between the two groups(P>0.05).A total of 40 patients in the two groups were readmitted for prophylactic transcatheter arterial chemoembolization(TACE)1 month after after central hepatectomy.Imaging examination showed that the liver parenchyma was evenly enhanced,the preserved liver vascular system was clearly displayed,and no stenosis was found in the portal vein system or hepatic venous system.Conclusion Liver section sealing management in central hepatectomy is simple,safe and reliable,which can effectively reduce the early postoperative ascites,and provide a new alternative for liver section management.关键词
中央肝切除术/肝断面处理/胶封法/敞开法/术后并发症Key words
central hepatectomy/liver section management/sealing management/open management/postoperative complication分类
医药卫生引用本文复制引用
刘俊涛,杨寿璋,屠金夫,蔡华杰..肝断面胶封法处理在中央肝切除术中的应用[J].肝胆胰外科杂志,2025,37(8):511-515,523,6.基金项目
温州市科技局基础性医疗卫生科技项目(Y2020042). （Y2020042）
