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Resection of the Caudate Lobe Tumor of Liver

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The Chinese-German Journal of Clinical Oncology 2002年第1期1卷 19-20页

作者： ZHOU Weiping, wu mengchao, YAO Xiaoping Eastern hepatobiliary surgery hospital, second military medical university, shanghai 200438, china Eastern hepatobiliary surgery hospital Second Military Medical University Shanghai China

Objective To analyze the operative technique and results of the resection for caudate lobe carcinoma of the liver. Methods The liver was fully freed of the ligments, short hepatic veins were divided and sutured, and the tumor was then freed from the inferior vena cava(IVC) . The caudate lobe was resected alone or in combination with other segment.Results 28 patients underwent resection of caudate lobe tumor. The number of the short hepatic veins transected and tied was 2-5 ( mean 3) . An intermittent Pringle' s manoeuver was used in 26 patients with a median occlusion time of 21.7 ( range 10-32) min. The median blood loss was 574 (range 100? 300) ml. No major complications such as massive bleeding and biliary fistula occurred. Intraop-erative total vascular occlusion was perfored on only 5 cases. All patients were discharged from the hospital. Outpatient periodic TAE plus chemotherapy was performed. Postoperative recurrence and metastasis was found in 13 cases,with 5 deaths.Conclusion The use of third porta hepatis dissection for resection of the caudate lobe tumor can reduce the risk of massive bleeding during the operation and can raise the rate of resection of caudate lobe tumor.

关键词： liver neoplasms hepatectomy

Resection of Huge Liver Cancer Involving the second Porta Hepatis: A Report of 55 Cases

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The Chinese-German Journal of Clinical Oncology 2002年第1期1卷 9-12页

作者： CHEN Han, wu mengchao, WANG Yi, WEI Gongtian, HU Lei Eastern hepatobiliary surgery hospital, second military medical university, shanghai 200438, china Eastern hepatobiliary surgery hospital Second Military Medical University Shanghai China

Objective To investigate the possibility and surgical procedures for huge liver cancer involving the second porta *** 55 cases of huge liver cancer, with the diameter of 8-28 cm(mean 12.7 cm) were studied. Right subcostal or “rooftop” incision was made, the liver ligments were divided, good exposure of the tumor and access to retrohepatic inferior vena cava were *** were completed under intermittent interruption of first porta hepatis. Occluding tape around vena cava was applied before liver resection if *** All tumors were successfully resected without death during *** longest survival time was now 4 years in one case. The 1-4 year postoperative survival rates were 63%,50%,50% and 30% *** Young patients with solitary large liver tumor, which grows slowly over a long period on basis of non-cirrhotic or mild cirrhotic liver, should undergo an exploration in an attempt of resection irrespective of the image contraindication, provided that there is no extra-hepatic metastasis.

关键词： liver neoplasms hepatectomy

Resection of Giant Hepatic Cavernous Hemangiomas after Dissection of the Third Porta Hepatis

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The Chinese-German Journal of Clinical Oncology 2002年第1期1卷 13-15页

作者： YAO Xiaoping, ZHOU Weiping, WANG Yi, wu mengchao, JING Liang Eastern hepatobiliary surgery hospital, second military medical university, shanghai 200438, china Eastern hepatobiliary surgery hospital Second Military Medical University Shanghai China

Objective To establish a novel and safe operation technique for the resection of giant hepatic cavernous hemangiomas involving the retro-hepatic vena cava.Methods After ligating the hepatic artery of affected lobe, the short hepatic veins at the third porta hepatis were dissected and ligated individually to separate the tumor from the retrohepatic vena cava, followed by the resection of the tumor under intermittent interruption of the porta hepatis.Results A total of 62 giant hepatic cavernous hemangiomas were successfully resected without hepatic vascular exclusion. Right and caudate lobectomies were done in 27 cases, right hemihepatectomies in 5 cases, right upper segmentectomies in 7 cases, right posterior lobec-tomies in 7 cases, extended left and caudate lobectomies in 10 cases, and caudate lobectomies in 6 cases. The blood transfusion requirement during operation was 1 400 ml on average. All did well postoperatively during a follow up of 4 - 84 months.Conclusion It is safe and feasible to resect giant hepatic cavernous hemangioma following dissection of the third porta hepatis. During operation the key step is dissection of the short hepatic veins.

关键词： liver cavernous hemangioma

Endoscopic Palliative Treatment for Malignant Obstructive Jaundice: A Report of 929 Cases

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The Chinese-German Journal of Clinical Oncology 2002年第1期1卷 32-35页

作者： HU Bing, ZHOU Daiyun, GONG Biao, WANG Shuzhi, wu mengchao Eastern Hepatohiliary surgery hospital, second military medical university shanghai 200438, china eastem hepatobiliary surgery hospital Second Military Medical University Shanghai China

Objective To review the experience with endoscopic palliative treatment for malignant obstructive jaundice (MOJ) in 929 patients. Methods 929 patients (598 males and 331 females) underwent 1 215 endoscopic palliative drainages for MOJ in our hospital. Tumor obstruction occurred in the distal common bile duct (CBD) (263 patients) , the middle CBD (43), and the hilum (909) . The mean biliru-bin level was 284.3umol/L( range 26 - 810) . Of the 1 215 drainages, 599 were performed by stenting with plastic endoprosthesis, 385 by naso-biliary catheterization, 167 by expandable metal stents, 39 by combined drainage method, 19 by tumor sphincterotomy and 6 by endoscopic fistulostomy.Results The successful rate of endoscopic procedure was 94.3 % . The jaundice symptom was improved in 81.8 % of the patients with a significant reduction of serum bilirubin in 64.7% . The complication after treatment occurred in 23 cases (2.6%), including cholangitis (23 cases), pancreatitis (8 cases), and bleeding (one case), and 3 cases were dead (0.2%) . The median survival time of all patients was 14 months and life time analysis showed a life expectancy of 75.9% , 44.0% and 25.2% at 1, 2 and 3 years respectively. Conclusion In the patients with MOJ secondary to pancreatobiliary malignancy, successful endoscopic drainage provides adequate relief of biliary obstruction and is associated with low morbidity and mortality. Endoscopic interventional treatment may be considered as an alternative of palliative biliary operation for the late stage of pancreatic and biliary malignancies.

关键词： biliary tract neoplasm jaundice cholangiopancreatography, endoscopic retrograde

Evaluation of α-L-Fucosidase in the Diagnosis of Primary Hepatic Carcinoma

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Journal of medical Colleges of PLA(china) 1989年第1期4卷 21-24页

作者：杨甲梅吴孟超陈汉 Institute of hepatobiliary surgery Changhai Hospital Second Military Medical University Shanghai

α-L-fucosidasc (AFU) activity was determined by referring to Troost’s method in sera, liv-er tissues and lesions from patients with hepatoccllular carcinoma (HCC), other liverspace-occupying lesions (SOL) and diseases. The results showed that the sensitivity and specificityfor the diagnosis of HCC were 81.2% and 83. 3% respectively with the assay of serum AFU activi-ty, and sensitivities in the diagnosis of AFP-negative and early HCC were 76.1% and 70. 8%,respectively. The AFU activity in the HCC tissues and their pericancerous liver tissues was twice asmuch as controls, and consisted with their serum AFU activity (r=0. 742, P<0.01). It is sug-gested that AFU could be a new biologic marker of HCC and have an important value in thediagnosis of HCC.

关键词： hepatoma α-L-fucosidase diagnosis α-fetoprotein liver diseases

Some Biopathological Characteristices of Small Hepatocellular Carcinoma and Their Clinical Significances

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Journal of medical Colleges of PLA(china) 1989年第4期4卷 348-350,389页

作者：丛文铭吴孟超张秀忠 Institute of hepatobiliary surgery Second Military Medical UniversityShanghai 200433

A gross morphological classification of 66 small hepatocellular carcinomas (SHCC,≤3 cm in diameter)and a determination of the DNA-content in 20 SHCC and 26 LHCC(larger hepatocellular carcinoma,>3 cm in diameter)by image analysis technology were studiedin this *** was showed that SHCC could be divided into three types:Type I,non-capsule type (n=13,19.7％);type II,capsule type(n=47,71.2％) and Type III,infiltrative type (n=6,9.1％).The Type I and Type II SHCC mainly had diploid DNAstem line,while Type III SHCC mainly haa aneuploid DN A stem *** patients with≤3cmSHCC,the postoperative 5-year survival rate was 75％,significantly higher than that of 42.3％in patients with>3 cm LHCC (P<0.05).There was no positive correlation between the tu-mor size and serum AFP level in this *** results suggest that SHCC of≤3 cm in sizebasicaily reflects the relatively berugn btotogical characteristics of early hepatocellular carcinomaand is the best opportunity to acmeve the best curative *** a small part of SHCC ex-presses markediy increased malignant biological behaviours due to the acceleration of stem *** to now,as to the atscovery of the SHCC,the quantitative measurement of serumAFP level is still an effective and generally accepted method.

关键词： liver cell cancer DNA image analysis technology serum AFP

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手术切除治疗原发性肝癌的疗效评价

上海医学 1999年第1期22卷 19-21页

作者：杨广顺吴孟超陈汉杨甲梅姚晓平吴伯文第二军医大学东方肝胆外科医院

目的评价原发性肝癌手术切除治疗后的疗效。方法分析１９６０年１月至１９９６年９月原发性肝癌３９３２例行手术切除治疗后手术死亡率和生存率。结果比较１９６０～１９７７年（ｎ＝１８１）、１９７８～１９８９年（ｎ＝９２１）、１... 详细信息

目的评价原发性肝癌手术切除治疗后的疗效。方法分析１９６０年１月至１９９６年９月原发性肝癌３９３２例行手术切除治疗后手术死亡率和生存率。结果比较１９６０～１９７７年（ｎ＝１８１）、１９７８～１９８９年（ｎ＝９２１）、１９９０～１９９６年（ｎ＝２８３０）三阶段，术后死亡率分别为８．８４％、０．４３％、０．３５％，而５年生存率分别为１６．０％、３０．６％、４８．６％。比较局部肝切除术（ｎ＝９０２）与规则性肝切除术（ｎ＝１１４９）表明，局部切除术手术死亡率低（０．１０％对４．７％，Ｐ＜０．０５），而５年生存率两者无明显差异（３６．１％对４０．３％，Ｐ＞０．０５）。比较大肝癌（＞５ｃｍ，ｎ＝３２２３）与≤５ｃｍ肝癌（ｎ＝７０９）和≤３ｃｍ肝癌（ｎ＝２４１）资料，１、３、５年生存率分别为６２．５％、４２．６％、２７．５％；８９．９％、８５．０％、７９．８和９５．５％、９１．７％、８５．３％。肝癌切除加门静脉（ｎ＝６５）或胆管内（ｎ＝２３）癌栓清除术治疗肝癌伴有癌栓者，术后２年生存率分别为２５．３％和３６．５％。肝癌切除加脾切除和／或门奇断流术治疗肝癌合并门静脉高压者（ｎ＝４８），术后１、２年生存率为８３．４％和７５．２?

关键词：原发性肝肿瘤外科手术疗效

肝癌切除手术前后周围静脉血液中AFPmRNA的变化及其意义

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中华实验外科杂志 1998年第5期15卷 410-411页

作者：刘扬张柏和钱光相陈汉吴孟超第二军医大学东方肝胆外科医院上海200438

目的探讨肝癌切除手术前后周围静脉血液中AFPmRNA的变化及其意义。方法应用巢式RT-PCR检测术后48小时、72小时及术后1周肝癌患者周围静脉血液中AFPmRNA,并观察变化。结果28例术前血液中AFPmRNA阴性的肝癌患者中有4例术后48小时转为阳性(... 详细信息

目的探讨肝癌切除手术前后周围静脉血液中AFPmRNA的变化及其意义。方法应用巢式RT-PCR检测术后48小时、72小时及术后1周肝癌患者周围静脉血液中AFPmRNA,并观察变化。结果28例术前血液中AFPmRNA阴性的肝癌患者中有4例术后48小时转为阳性(14.30%),但术后1周时复转阴性;而16例术前血液中AFPmRNA阳性的肝癌患者中有4例(25.00%)术后72小时转为阴性。结论手术操作可引起肿瘤细胞播散人血循环,但它不增加手术危险性。术后短期适量应用γ-干扰素或白介素2(IL-2)是必要的。

关键词：肝细胞瘤肝肿瘤 AFPmRNA 切除术

肝细胞生长因子及其受体基因在大鼠肝脏癌变过程中的表达

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外科理论与实践 1998年第1期3卷 33-35页

作者：罗运权吴孟超陈汉第二军医大学东方肝胆外科医院 200433

目的:了解肝细胞生长因子(HGF)及其受体基因在大鼠肝脏癌变过程中的表达变化规律,以及这些变化与肿瘤生物学行为的关系.方法:以二乙基亚硝胺(DENA)诱发的大鼠肝癌模型为对象,采用地高辛标记的HGF及其受体DNA探针,检测HGF及其受体基因在... 详细信息

目的:了解肝细胞生长因子(HGF)及其受体基因在大鼠肝脏癌变过程中的表达变化规律,以及这些变化与肿瘤生物学行为的关系.方法:以二乙基亚硝胺(DENA)诱发的大鼠肝癌模型为对象,采用地高辛标记的HGF及其受体DNA探针,检测HGF及其受体基因在大鼠肝脏癌变过程中的表达.结果:HGF及其受体基因在大鼠肝脏组织中均有表达,但在诱癌的不同时期,其表达阳性率差异明显,HGF表达阳性率在肝硬变前期达最高,肝硬变期次之,癌变期与正常对照相比差异无显著意义.HGF受体基因表达阳性率随肝组织逐渐癌变呈逐渐增加趋势,以癌变期为最高,正常肝组织中未见表达.结论:HGF及其受体基因过量表达与大鼠肝脏癌变的演化过程关系密切,HGF及其受体系统对调节肿瘤生长、转移起重要作用.

关键词：肝肿瘤肝细胞生长因子受体基因表达