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Permalink : https://petit.lib.yamaguchi-u.ac.jp/4972
山口医学 Volume 53 Issue 3
published_at 2004-06-30
UppergGastro-intestinal disorder after left hepatectomy
肝左葉切除後の上部消化管障害とその対策
Mori Naohide
Okada Toshimasa
Takemoto Norikazu
Hashimoto Kiichirou
Tangoku Akira
About This Article
Descriptions
肝切除後に強い摂食障害が遷延した3症例を経験した.全例が左葉切除であったため,術式に特徴的な合併症ではないかと考えその発生機序について検討した.同時期の右葉切除群(10例)と左葉切除群(10例)を比較したところ,上部消化器症状は右葉切除群で1例に軽度の症状を認めた.一方,左葉切除群では5例に認め,うち3例は高度の摂食障害が遷延した.このうちの2例の胃透視にて幽門部～体部の頭側への挙上による胃の高度変形を認め,これが原因と予想された.術後の腹部CTで胃底部と幽門部の高低差を左葉切除の無症状群(5例)と有症状群(5例)で比較したところ,有意差をもって有症状群の高低差が小さかった.このことから左葉切除後の上部消化管障害は死腔への胃の高度の落ち込みが原因の一つと考えられた.その後5例に大網の腹壁への固定を行い落ち込みを回避したところ,良好な術後経過を得ている.
Creator Keywords
肝左葉切除
上部消化管障害
術後合併症
Rights
本文データは山口大学医学会の許諾に基づきCiNiiから複製したものである
Other Article
PP. 127 - 131