腹腔镜肝切除术  

Laparoscopic resection of the left lateral lobe of the liver

作　　者：刘连新[1] 麻勇[1] 

机构地区：[1]哈尔滨医科大学附属第一医院肝脏外科,150001

出　　处：《中华普外科手术学杂志（电子版）》2014年第1期34-34,共1页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金(81272705);教育部创新团队发展计划(IRT1122)

摘　　要：目的展示应用腹腔镜肝切除手术治疗肝脏左外叶肿瘤的1个病例。方法该患者为41岁女性,肝左外叶肿瘤直径为5.5 cm,肝功能检测为Child-Pugh A级,吲哚氰绿15 min潴留率(ICG15)为8.9%。术前手术方案评估表明为腹腔镜肝切除手术的适应证。患者术中采用仰卧位,共应用5个trocar(即5个穿刺孔)。手术的初始操作为游离肝周韧带,肝实质的离断应用超声刀和可吸收血管夹来完成。结果手术时间为115 min,出血量为110 ml,除了常规进行预存式自体输血外,无需额外输血。病理结果提示为肝脏囊腺瘤。患者术后恢复良好,无手术并发症发生,术后第8天出院。结论对于具备肝胆手术以及腹腔镜手术操作经验的外科医生而言,腹腔镜肝切除手术是治疗肝脏外科疾病的一种安全、有效的方法。Objective To present a case of laparoscopic resection of a tumor at the left lateral lobe of the liver. Methods A 41-year-old female patient had a tumor in a diameter of 5.5 cm located at the left lateral lobe of the liver. Her liver fuction was Child-Pugh A and a 15-minute retention rate for indocyanine green （ ICG15 ） was 8. 9%. Preoperative evaluation showed that she was indicated for laparoscopic liver resection. A 5-trocars method was used for surgical procedures in a supine position. The operation began with dissection of ligaments of the liver. Parenchymal transection was performed using an ultrasonic knife and absorbable vascular clamps. Results The operation time was 115 minutes and intraoperative blood loss was 110 ml. Additional blood transfusion was not required except for routine autotransfusion. Pathological examination confirmed the diagnosis of a hepatic cystadenoma. Postoperative recovery was uneventful and the patient was discharged on day 8 after operation. Conclusions Laparoscopic liver resection is a safe and effective procedure in the management of liver disease that could be used by well-trained hepatobiliary surgeons.

关 键 词：腹腔镜检查 肝切除术 

分 类 号：R657.3[医药卫生—外科学]