CLINICAL STUDY OF MESOHEPATECTOMY

Objective To evaluate the surgical technique and effects of mesohepatectomy for treatment of centrally located hepatic tumor in 12 cases.Methods Analyse the data of 12 patients underwent mesohepatectomy in our department from August 2006 to April 2008 retrospectively.The preoperative liver function was graded as A in 8 patients and B in 4 patients.Liver cirrhosis was in 8 patients.Pringle's maneuver applied in 7,and total hepatic vascular exclusion in 2,the occlusion time ranged from 15~40 and 25~45 minutes,respectively.Three cases underwent segments Ⅳ,Ⅴ,Ⅷ hepatectomy and 6 segments Ⅳb and Ⅴ hepatectomy,all combined cholecystectomy.2 cases underwent segments Ⅳa and Ⅷ hepatectomy,and 1 segment Ⅷ hepatectomy.Prophylactic exploration of the common bile duct was in 4 patients.Results 400 ml intraopertive blood transfusion was performed in 1 case.The duration of operation in all cases were successfully.The diameters of excisional liver specimen measured 5-15cm,and 7.5cm in average.There was no operative death.The postoperative complications were: 1 was with obstructive jaundice and billiary fistula;3 with encapsulated coelio-effusionthere;1 with pulmonary infection and 1 with infection of incisional.Histologic diagnosis: primary hepatic carcinoma was in 8,liver metastasis neoplasma in 1,carcinoma of gallbladder in 1,Mesenchymal hamartoma in 1,hepatoblastoma in 1.All patients were follow-up,ranged from 1-32 months.Conclusion Mesohepatectomy is a complicated technique,but it may be seen as an effective method to cure many kinds of tumor centrally located in liver,including hepatocarcinoma,and using the technique of blockage of liver blood flow selectively is an important measure to control bleeding in hepatectomy.