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中华肝脏外科手术学电子杂志

中华肝脏外科手术学电子杂志 ›› 2024, Vol. 13 ›› Issue (02) : 134 -139. doi: 10.3877/cma.j.issn.2095-3232.2024.02.003

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肝切除术中肝血流控制技术研究进展
唐亦骁1, 何心渝1, 徐骁2, 卫强3,†()   
  1. 1. 310006　杭州，浙江中医药大学第四临床医学院；310006　杭州市第一人民医院肝胆胰外科
    2. 310058　杭州，浙江大学医学院
    3. 310006　杭州，浙江中医药大学第四临床医学院；310006　杭州市第一人民医院肝胆胰外科；310058　杭州，浙江大学医学院
  • 收稿日期:2023-10-24 出版日期:2024-04-10
  • 通信作者: 卫强
  • 基金资助:
    国家重点研发计划(2021YFA1100500); 国家自然科学基金重大研究计划(92159202); 浙江省医药卫生科技计划-省部共建重点(WKJ-ZJ-2120)

Research progress in hepatic blood flow control technology during hepatectomy

Yixiao Tang1, Xinyu He1, Xiao Xu2, Qiang Wei3,†()   

  1. 1. Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310006, China; Department of Hepatobiliary and Pancreatic Surgery, Hangzhou First People's Hospital, Hangzhou 310006, China
    2. Zhejiang University School of Medicine, Hangzhou 310058, China
    3. Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310006, China; Department of Hepatobiliary and Pancreatic Surgery, Hangzhou First People's Hospital, Hangzhou 310006, China; Zhejiang University School of Medicine, Hangzhou 310058, China
  • Received:2023-10-24 Published:2024-04-10
  • Corresponding author: Qiang Wei
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唐亦骁, 何心渝, 徐骁, 卫强. 肝切除术中肝血流控制技术研究进展[J]. 中华肝脏外科手术学电子杂志, 2024, 13(02): 134-139.

Yixiao Tang, Xinyu He, Xiao Xu, Qiang Wei. Research progress in hepatic blood flow control technology during hepatectomy[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(02): 134-139.

术中出血是影响肝切除术后患者预后的重要因素，肝脏血流控制技术是减少术中出血的有效方法。各种肝血流控制技术有着各自的优缺点和适应证，需要临床医师充分了解、熟练掌握并个体化应用。目前，外科医师对于肝脏血流阻断技术的认识在临床实践中不断加深，其方法及临床应用也在不断改进和发展。本文就半肝入肝血流阻断法、全肝血流控制技术、Glisson蒂横断术、门静脉球囊阻断术等肝脏血流控制技术进展加以综述。

关键词: 肝脏切除术, 血流控制, Pringle法, 半肝入肝血流阻断法, 全肝血流控制技术, Glisson蒂横断术, 门静脉球囊阻断术

Intraoperative bleeding is a critical factor affecting clinical prognosis of patients after hepatectomy, and hepatic blood flow control technology is an effective method to minimize intraoperative bleeding. Different hepatic blood flow control technologies have their own advantages, disadvantages and indications. Hence, clinicians should fully understand, master and apply each technology in an individual manner. At present, surgeons' understanding of hepatic blood flow occlusion technology has been deepened in clinical practice, and specific methods and clinical applications have also been constantly improved and developed. In this article, progresses in hepatic blood flow control technologies, such as semi-hepatic inflow occlusion, total hepatic blood flow control, Glisson pedicle transection and portal vein balloon occlusion and so on, were reviewed.

Key words: Liver resection, Blood flow control, Pringle maneuver, Hemihepatic vascular control, Total hepatic vascular exclusion, Glisson pedicle transection, Balloon occlusion of portal vein
图1 肝脏血流控制技术示意图注：a为全入肝血流阻断法；b1为右半肝入肝血流阻断法，b2为左半肝入肝血流阻断法；c为Glisson蒂横断术；d为球囊阻断术；e为全肝血流阻断法；f为选择性全肝血流阻断技术
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