区域性出入肝血流阻断在腹腔镜左半肝切除术中的应用  

Application of regional hepatic in- and outflow occlusion for laparoscopic left hemi-hepatectomy

作　　者：段云飞[1] 杨雨[1] 陈晶[1] 邬迪 孙冬林[1] Duan Yunfei;Yang Yu;Chen Jing;Wu Di;Sun Donglin(Department of Hepatopancreatobiliary Surgery,the Tthird Affiliated Hospital,Soochow University,Changzhou 213000,China)

机构地区：[1]苏州大学附属第三医院肝胆胰外科,江苏省常州213000

出　　处：《中华普通外科杂志》2019年第1期10-13,共4页Chinese Journal of General Surgery

基　　金：江苏省第五期“333工程”培养资金资助项目(BRA2017118).

摘　　要：目的评估腹腔镜下区域性出入肝血流阻断的左半肝切除术与左半肝入肝血流阻断的优缺点。方法回顾性分析2016年1月至2017年12月苏州大学附属第三医院开展的腹腔镜区域性出入肝血流阻断左半肝切除术(34例),与以往左半肝入肝血流阻断法(52例)作对比,分析两组患者术前、术中及术后情况。结果与左半肝入肝血流阻断组相比,区域性出入肝血流阻断组由于解剖肝静脉导致手术时间延长约0.46h,但可降低术中出血约20ml,减少术中输血约0.62U,且未发生CO2气体栓塞,同时能减轻术中肝功能损伤,缩短术后住院时间约1.41d。结论腹腔镜下左半肝切除术时行区域性出入肝血流阻断可减少术中出血量、降低CO2气体栓塞发生危险、缩短术后住院时间。Objective To evaluate regional left sided in and out flow hepatic flow occlusion in laparoscopic left hemi-hepatectomy compared with in hepatic flow occlusion. Methods From Jan.2016 to Dec.2017,34 patients underwent laparoscopic left hemi-hepatectomy with regional hepatic in-out flow occlusion.Results were compared with 52 patients undergoing laparoscopic left hemi-hepatectomy under left-sided hepatic inflow occlusion only. Results Compared to hepatic inflow occlusion,regional hepatic in and out flow occlusion in laparoscopic left hemi-hepatectomy lead to a 0.46 hour longer operation time,20 ml less intraoperative blood loss and 0.62U less blood transfusion,reduced hepatic function impairment and 1.41 days shorter hospital stay. Conclusions Regional hepatic in-out flow occlusion in laparoscopic left hemi-hepatectomy can reduce intraoperative hemorrhage and lower the risk of CO2 embolism.

关 键 词：肝肿瘤 肝切除术 腹腔镜 栓塞 空气 

分 类 号：R657.3[医药卫生—外科学]