Habib 4X射频凝固设备辅助腹腔镜无血切肝的临床研究  

Laparoscopic Habib 4X bipolar radiofrequency device in laparoscopic liver resection

作　　者：王爱东[1] 胡益挺[1] 陈志红 李振宇[1] 余力 张法标[1] 蔡柳新[1] 方哲平[1] 季一鸣[1] 

机构地区：[1]浙江省台州医院肝胆外科,临海317000 [2]超声影像科 [3]服务中心

出　　处：《中华肝胆外科杂志》2012年第11期827-830,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：浙江省卫生厅基金资助项目（2011KYAl59）

摘　　要：目的研究应用Habib4X双极射频设备辅助腹腔镜切肝的应用价值。方法对2009年9月至2012年4月我院31例腹腔镜Habib4X射频辅助肝切除病例的手术和临床效果进行分析。结果30例完成腹腔镜下手术，1例中转开腹。其中左肝外叶切除12例，左半肝切除1例，第V或第Ⅵ肝段切除9例，Ⅴ、Ⅵ肝段联合切除2例，肝楔形切除6例。联合胆囊切除2例。切肝时间10-68min，中位切肝时间24min；出血量8-370ml，平均（145±75）ml。术后肝功能指标轻度异常，经护肝治疗3-5d恢复正常。术后平均住院时间7．8±2．6（3-12）d。无术后出血、胆漏及感染并发症。结论对于Ⅱ、Ⅲ、Ⅳa、Ⅴ、Ⅵ肝段病灶的腹腔镜肝切除，应用Habib4X射频凝固断肝技术，无需肝门解剖和血流阻断，可提高切肝速度，减少术中出血，降低术后肝功能异常程度，降低肝癌病灶切缘局部复发的风险，值得临床推广应用。Objective To evaluate the efficacy of laparoscopic Habib 4X （Habib 4X, Anglo Dynamics US）, a new bipolar radiofrequency （RF） device, in laparoscopic liver resection. Methods Thirty-one patients who underwent laparoscopic liver resection using the laparoscopic Habib 4X from Sept 2009 to Apr 2012 were studied retrospectively. Results The laparoscopic Habib 4X was success- fully used in 30 patients （malignant, n = 18 ; benign, n= 12）. The procedures performed included left lateral sectionectomy （n= 12）, left hemi-hepatectomy （n= 1）, Ⅴ or Ⅵ segmentectomy （n= 9）, Ⅴ and Ⅵ bi-segmentectomy （n= 2） and wedge exclusion （n= 6）. The time required for precoagulation and resection was 10-68 min （median 24 rain）. The mean intraoperative blood loss was 145 ±75ml （range 8-370 ml）. Mild abnormal liver function which returned to normal in 3 to 5 days was detected postoperatively. The mean hospital stay was 7.8±2.6 d （range 3-12 days）. There was no patient who developed postoperative bleeding, bile leakage or abdominal abscess. For cancer patients, there was no local recurrence on follow-up. Conclusion Laparoscopic Habib 4X, a device when used in lap- aroscopic liver resection, resuhed in minimal blood loss and quick recovery. It had only mild effect on liver function and it had low morbidity. In addition, it might reduce the risk of local recurrence in ma- lignant turnouts.

关 键 词：腹腔镜肝切除 Habib 4X 失血量 

分 类 号：R657.3[医药卫生—外科学]