腹腔镜肝脏肿瘤切除术40例  

Laparoscopic hepatectomy for liver tumors

作　　者：汤晓东[1] 刘双海[1] 赵振国[1] 陈胜[1] 

机构地区：[1]东南大学医学院附属江阴医院肝胆外科,江苏省214400

出　　处：《中华普通外科杂志》2014年第10期753-755,共3页Chinese Journal of General Surgery

摘　　要：目的 探讨腹腔镜肝切除术治疗肝脏肿瘤的可行性及临床应用价值.方法 回顾性分析我院2010年5月至2013年10月期间由同一术者实施的40例腹腔镜肝切除术患者的临床资料,其中原发性肝细胞性肝癌27例,直肠癌肝转移2例,肝脏囊腺瘤2例,肝囊肿1例,肝脏血管瘤5例,肝局灶性结节性增生3例,病灶直径3.0- 10.0 cm,平均（4±4） cm.结果 所有患者均顺利完成手术,无中转开腹及围手术期死亡病例.其中不规则肝切除术21例,肝左外叶切除术12例,左半肝切除术3例,肝Ⅵ段切除术4例.手术时间为75 -265 min,平均（166±109） min,术中出血80-750ml,平均（480±233） ml.其中2例肝细胞性肝癌患者术后病理切缘为阳性.术后1例患者出现胆漏,1例患者出现腹水,均予以保守治疗后康复,术后平均住院（7±14）d.结论 在充分掌握适应证和手术技巧的情况下,腹腔镜肝切除术治疗肝脏肿瘤安全可行.Objective To evaluate the feasibihty and clinical value of laparoscopic hepatectomy for liver tumors.Methods Laparoscopic hepatectomy from May 2010 to Oct 2013 was summarized including 27 cases of primary hepatocellular carcinoma,5 cases of liver hemangioma,3 cases of hepatic nodular hyperplasia,2 cases of liver metastases of colorectal cancer,2 cases of liver cystadenoma and 1 case of liver cyst.The diameter averaged at （4 ± 4） cm.Results All patients were successfully operated,no perioperative death.Irregular hepatectomy was performed in 21cases,hepatic left lateral lobectomy in 12 cases,segment VI resection in 4 cases and left hepatectomy in 3 cases.Operative time averaged （166 ± 109） min.Average blood loss was （480 ± 233） ml.Tumor margin was positive in two HCC cases.Bile leakage and ascites developed in one each patient,who were then cured by conservative treatment.Conclusions Laparoscopic hepatectomy for liver tumors is safe and feasible.

关 键 词：肝肿瘤 肝切除术 腹腔镜 

分 类 号：R735.7[医药卫生—肿瘤]