摘要： 目的：研究联合尾状叶切除的半肝切除术的合理性和可行性，并探讨其适应症。方法：回顾性分析实施的31例联合部分或全部尾状叶切除的半肝切除术病例，其中包括原发性肝癌16例，肝转移癌1例，肝门部胆管癌5例，肝内胆管结石4例，肝巨大血管瘤3例，肝炎性假瘤1例，肝外伤1例。结果：手术完成时间130min~367min，平均218±61 min。术中出血80ml~1100ml，平均350±283 ml，19例病人术中未输血。无围手术期死亡。术后并发症总发生率为35.5%(11/31)。其中，右侧胸腔积液5例；切口脂肪液化2例；轻度肝性脑病1例；胆漏3例，均经保守治疗而愈。结论：肝脏的良性或恶性病变侵及尾状叶时，实施联合尾状叶的半肝切除术是安全可行的。 关键词：半肝切除术， 尾状叶切除术，并发症发生率，死亡率

Hemihepatectomy combined with caudate lobectomy: report of 31 cases Baomin Shi, Zhenhai Zhang, Zhongxue Su, Chengkun Qin, Jian Xu, Qingling Mu, Taihuang Wu Department of Hepatobiliary Surgery, Shandong Provincial Hospital of Shandong University, Jinan, 250021, China Objective: To explore the rationality and possibility of right or left hemihepatectomy combined with partial or whole caudate lobectomy and analyze its indications. Methods: Thirty-one patients surgically treated by hemihepatectomy combined with caudate lobectomy were retrospectively studied. The primary lesions included hepatocellular carcinoma(n=16), hilar cholangiocarcinoma(n=5), giant hemangioma(n=3), hepatolithiasis(n=4), hepatic metastasis(n=1), liver injury(n=1), hepatic inflammatory pseudotumor(n=2). Sixteen of the total were operated with right hemihepatectomy combined with caudate lobectomy and fifteen of them with left hemihepatectomy combined with caudate lobectomy. Result: The average operating time was 218±61 min(130min~367min). The average amount of blood loss was 350±283 ml(80ml~1100ml). Nineteen of the total were not given transfusion because their blood loss were less than 300ml during operation. The perioperative mortality was 0 and total morbidity was 35.5%(11/31), including pleural effusion(n=5), fat liquefaction of incision(n=2), slight hepatic encephalopathy(n=1), biliary leakage(n=3). All complications were treated successfully without operation. Conclusion: Liver lesions involving caudate lobe, either benign or malignant, could be safely and effectively by hemihepatectomy combined with partial or whole caudate lobectomy. Key words: hemihepatectomy, caudate lobectomy, morbidity, mortality