男子肝上长16公斤血管瘤 医生手术8小时成功切除
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近日,中日友好医院肝胆外科的杨志英教授和他的团队历经8小时30分钟的奋战,完成了一台“肝脏超巨大血管瘤剥除术”。切下的肿瘤经测量,
最大直径50厘米,重达16公斤。患者目前术后恢复顺利。
据介绍,1个月前,一位33岁的青年人来到肝胆外科诊室。他挺直了腰板坐在凳子上,明显向前凸起的肚子与他瘦削的身体不协调。当他拿出腹部CT片时,在场的医生震惊了,片子上展现出的是一个50厘米×35厘米×18厘米的巨大肝脏血管瘤。患者说,5年前发现血管瘤时,其直径就已达20多厘米,辗转多家医院,均因风险太大,无法手术。接受介入栓塞治疗后,血管瘤仍不断增大,患者无法平卧,饮食和活动都受到了严重影响,且面临血管瘤破裂的危险。
杨志英介绍说,团队此前曾有成功切除直径37厘米肝血管瘤的经验,加上麻醉、ICU、输血科等强大的技术支持和保障,可以考虑手术。经过术前讨论和准备,该团队制定了周密完善的计划。
杨志英说,这种良性肿瘤被称为海绵状血管瘤,由增生的血管团组成,内部充满了血液,表面薄如蝉翼,一旦破裂,将导致难以控制的大出血。由于这个巨大的血管瘤已占据了患者整个腹腔,手术难点在于快速控制肝脏重要的供血通路—肝十二指肠韧带内的肝动脉和门静脉。手术团队凭借多年来积累的经验,快速找到了肝十二指肠韧带,阻断肝门,将血管瘤中的血液放出,并利用自体血回输设备,将放出的血液重新输回患者体内。经过8小时30分钟的手术,肿瘤终于被剥除。
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