摘要目的 评价精准肝切除在复杂肝脏占位性病变外科治疗中的价值.方法 分析2006年5月至2009年6月间65例复杂肝脏占位性病变的治疗方法 和结果 .其中51例患者进行了治愈性肝切除,包括16例肝脏三区切除、11例半肝切除、5例肝中叶切除、3例联合肝段切除、5例尾叶切除、11例不规则肝切除.结果 51例实施了治愈性肝切除患者的围手术期死亡率为零,术后主要并发症发生率9.8%(5/51).19例实施了血管修复/重建的病例在随访结束时血管通畅.10例良性病变的病例术后1年存活率100%,41例恶性肿瘤肝切除术后1年存活率92.7%.未实施手术治疗的14例恶性肿瘤病例均在1年内死亡.结论 对于部分传统经验评估认为不可切除的复杂肝脏占位性病变,精准肝切除作为一种积极的外科治疗具有重要的临床价值.

abstractsObjective To evaluate the early results of precise liver resection. Methods Between May 2006 and June 2009,65 patients with complicated liver space-occupying lesions were included in the study.Fifty-one patients underwent curative liver resection.Liver resections performed included 16 trisectionectomies.11 hemihepatectomy,5 mesohepatectomies,3 combined segmentectomies,5 caudate Iobectomies and 11 irregular local resections.Results Patients undergoing resection had no mortality with a major morbidity of 9.8%.Nineteen vascular repairs and reconstructions were patent at last follow-uD.The postoperative 1-year survival rate was 100% in 10 patients with benign lesions and 92.7%in 41 patients with malignant tumors.The 1-year survival rate waa zero in patients with malignant tumors.who underwent no liver resection.Conclusions Precise liver resection,as an aggressive surgical approach,offers hope for these patients,who would otherwise have a dismal prognosis.