腹腔镜肝肿瘤切除术21例临床分析  

Clinical analyses of laparoscopic hepatectomy for liver neoplasms： a report of 21 cases

作　　者：黄东方[1] 张建淮[1] 吴金声[1] 王绍闯[1] 刘磊[1] 

机构地区：[1]南京医科大学附属淮安第一医院肝胆胰外科,223300

出　　处：《中华全科医师杂志》2013年第7期574-576,共3页Chinese Journal of General Practitioners

摘　　要：2007年12月至2012年10月我院行腹腔镜肝肿瘤切除术21例,其中11例为边缘型恶性肝肿瘤,直径1.0 ～ 9.0 cm（6例直径≤2.0 cm）,10例为边缘型良性肝占位病变；肿瘤部位CouinaudⅢ段13例、Ⅳ段内6例、Ⅴ段1例、Ⅵ段内1例；11例为肝细胞癌,7例为肝血管瘤,肝腺瘤1例,肝淋巴瘤1例,肝灶性坏死l例.手术切除均成功,无中转开腹,无胆漏、空气栓塞、死亡等手术并发症,平均手术时间（120±30）min,平均出血量（165±79）ml,术后1～2d开始进食和下床,术后1周外周血WBC计数、白蛋白、胆红素水平恢复正常,平均住院时间（16±10）d；1年生存率100％.合理选择手术适应证,腹腔镜肝肿瘤切除术安全、有效,尤其适用于周围型微小肝肿瘤.The clinical data were retrospectively analyzed for 21 cases of liver neoplasms undergoing laparoscopic hepatectomy from December 2007 to October 2012.Among 11 cases of borderline hepatocellular carcinoma （HCC） （1.0-9.0 cm）,6 of them were of micro hepatocellular carcinoma （MHCC） with a diameter ≤2 cm.There were 10 cases of borderline hepatic benign tumor,including liver hemangioma （n =7）,hepatic adenoma （n =1）,liver lymphoma （n =1） and liver focal necrosis （n =1）.According to Couinaud＇s liver segmentation method,neoplasm was located on segment Ⅲ （n =13）,segment Ⅳ （n =6）,segment Ⅴ （n =1） and segment Ⅵ （n =1）.Laparoscopic hepatectomy was successful in all patients.There was neither conversion into open approach nor postoperative complications of bile leakage,air embolism or perioperative mortality,etc.The mean operative duration was （120 ± 30） minutes,average hemorrhagic volume （165-±79） ml and normal diet ＆ ambulation at Day 1-2 post-operation.The average postoperative hospitalization stay was （16 ± 10）days and l-year survival rate 100%.The parameters of leucocyte,liver enzymes,albumin and bilirubin returned to normal at Week 1 post-operation.Once a reasonable surgical indication is selected,laparoscopic resection is both safe and effective for peripheral micro hepatocellular carcinoma.

关 键 词：肝肿瘤 腹腔镜检查 

分 类 号：R735.7[医药卫生—肿瘤]