Hepatic cavernous hemangioma suture

Treatment of diseases: hepatic cavernous hemangioma Indication Hepatic cavernous hemangioma is mainly surgical resection. For patients with a diameter of 10 cm or less and a tumor located at the center of the liver, hepatic hemangioma can be sutured. The surgical procedure is simple and reliable, and there is no need to remove a large amount of normal liver tissue. Postoperative hemangioma can be reduced and controlled to control its development. Preoperative preparation 1. Perform routine examinations and corresponding treatments before surgery. Cardiac and pulmonary function tests should be performed on patients over 50 years of age to assess tolerance to upper abdominal surgery. 2, liver CT and B-ultrasound should be performed before surgery to understand the location, extent and relationship with large blood vessels for intraoperative reference. 3, appropriate liver protection after admission, vitamin K11 injection 3d before surgery to enhance liver reserve function to improve blood coagulation mechanism. 4, according to the size of the tumor and the difficulty of surgery to prepare blood before surgery, in preparation for blood. Surgical procedure According to the incision of the hemangioma growth site according to the hepatectomy, the right or left marginal incision or other incision is selected for the abdomen. First explore the liver, carefully check the location and size of the hemangioma, especially the depth of the tumor into the liver parenchyma. Free liver according to the location. If the hemangioma is located in the right hemisphere, the right triangular ligament, right coronary ligament, right kidney and right colon ligament are disconnected; if located in the left hemisphere, the round ligament, hepatic ligament, left coronary ligament and left The triangular ligaments were separated, and the affected liver was well exposed. If the position of the hemangioma is easy to reveal, shallow, or directly suture. After the liver is freed, the hepatic hilum is blocked with a latex tube to tighten the hepatic duodenal ligament. After a few minutes, the tumor becomes soft and shrunk, and then a 13×34 standard large suture needle is used to wear 10-- No. 0 thick silk thread, from the normal hepatic tissue at the edge of the hemangioma, through the base of the tumor to the contralateral normal liver tissue, the "8" suture is not tied, and the same method is used to suture several needles. The needle spacing is 1.5 to 2 cm, then tighten the knot. Remove the hilar blocker. If there is oozing blood at the eye of the needle, it can be pressed with warm saline gauze for several minutes to stop bleeding. If there is still bleeding, the 8 shape suture can be used in the oozing place with a thin thread to stop bleeding. After checking for no bleeding, the incision was sutured by layer.

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