腹腔镜肝癌切除术16例临床分析  

Clinical Analysis on Laparoscopic Hepatectomy for Hepatocellular Carcinoma in 16 Cases

作　　者：王军[1,2] 王德鹏[1] 杨彦民[3,2] 

机构地区：[1]吉林市中心医院,吉林吉林132001 [2]佳木斯大学研究生院,黑龙江佳木斯154002 [3]佳木斯大学附属第二医院,黑龙江佳木斯154002

出　　处：《北华大学学报（自然科学版）》2015年第4期496-498,共3页Journal of Beihua University（Natural Science）

基　　金：黑龙江省自然科学基金项目(D201258)

摘　　要：目的：介绍采用HIFU及Endo -GIA成功行16例肝癌切除手术的经验与体会.方法选择左半肝及右肝浅表癌肿患者,肝功能Child分级A级15例,B级1例,采用超声刀（ High Intensity Focused Ultrasound,HIFU）及腹腔镜切割吻合器Endo -GIA行16例肝恶性肿瘤切除手术.结果15例患者顺利完成行腹腔镜肝癌切除,1例因出血改为开腹手术.左肝局部切除4例,左半肝切除1例,左外叶切除8例,肝右叶局部切除3例.手术时间80～220 min,平均105 min.术中出血量90～1000 mL,平均300 mL.病灶直径2～6.5 cm,平均4.5 cm,术后无并发症发生.结论对肝脏浅表肿瘤或左半肝的恶性肿瘤患者行HIFU及Endo-GIA腹腔镜肝癌切除术是可行和安全的。Objective To introduce new techniques for laparoscopic hepatectomy, High Intensity Focused Ultrasound （ HIFU） and Endo-GIA in 16 cases. Method 16 cases of superficial cancer were enrolled,including 15 cases of grade A and 1 case of grade B according to the liver function child-pugh classification. The surgeries were performed by using HIFU and Endo-GIA. Results Hepatectomy for liver cancer was performed successfully under laparoscope in 15 cases and a conversion to open surgery was required in 1 case because of intraoperative hemorrhage,including left liver partial resections in 4 cases, left half liver resection in 4 case left liver lobe resections in 8 cases,and right liver lobe partial resections in 3 cases. In the laparoscopic hepatectomy,the mean operative time was 105 min （80～220 min）,the mean blood loss was 300 mL （90～1 000 mL）,and the mean diameter of the lesions was 4. 5 cm （2 ～ 6. 5 cm）. No postoperative surgical complications were seen. Conclusion Laparoscopic hepatectomy is safe and feasible by using HIFU and Endo-GIA for malignant tumors located at the border of the liver,the surface of the right lobe,or the left lobe.

关 键 词：腹腔镜 肝切除术 肝癌 

分 类 号：R657.3[医药卫生—外科学]