腹腔镜刮吸法在肝切除术的临床应用  

Laparoscopic hepatectomy by curettage and aspiration: 54 cases reported

作　　者：蔡秀军[1] 虞洪[1] 梁霄[1] 王一帆[1] 林立忠[1] 张宇华[1] 陈继达[1] 王先法[1] 李立波[1] 彭淑牖[1] 

机构地区：[1]浙江大学医学院邵逸夫医院普外科,腔镜诊治中心,杭州310016

出　　处：《中华医学杂志》2005年第3期161-163,共3页National Medical Journal of China

基　　金：浙江省科技厅基金资助项目(2003C33055)

摘　　要：目的介绍采用刮吸法断肝技术施行54例腹腔镜肝切除术的经验和体会。方法采用多功能手术解剖器(Pengmultifunctionaloperativedissector,PMOD)来实施刮吸法断肝技术行腹腔镜肝切除术。结果本组54例行腹腔镜肝切除术,52例获得成功,其中2例分别因为肝硬化肝创面出血及腹腔严重粘连中转开腹手术。手术时间平均为1465min,术中平均出血量为460ml,切除肝脏的最大标本体积为20cm×7cm×4cm。1例术后出现肝创面胆漏,经再次手术治疗后痊愈。1例术后出现气胸,经胸腔闭式引流后痊愈。患者术后24h均能下床活动,术后1周出院。结论选择性的进行腹腔镜肝切除术是安全有效的方法,刮吸法断肝技术是理想的腹腔镜下切肝方法。Objective Introduce the experience on 54 cases of laparoscopic hepatectomy-liver transection by curettage and aspiration(LTCA) .Methods We used Peng multifunctional operative dissector(PMOD) to perform laparoscopic liver transection by curettage and aspiration. Results 52 patients underwent laparoscopic hepatectomy successfully. 2 patients were converted to an open hepatectomy for raw surface hemorrhage or severe abdominal cavity adherence. Mean operative time was 146.5 minutes, the mean bleeding volume was 460 mL, the largest excised liver size was 20 cm×7 cm×4 cm. Bile leakage and pneumothorax occoured in 2 patients. Patients could walk one day after operation and were discharged one week postoperatively. Conclusion Laparoscopic hepatectomy by curettage and aspiration is a safe and effective technique. PMOD is an optimal tool to perform laparoscopic hepatectomy.

关 键 词：刮吸法 腹腔镜肝切除术 临床应用 术后 痊愈 出院 PMOD 结论 技术 方法 

分 类 号：R657.3[医药卫生—外科学]