三步法断肝在完全腹腔镜左半肝切除中的应用研究  

Application of three-step liver resection approach in totally laparoscopic left hemihepatectomy

作　　者：王雪飞[1,2] 胡明根[3] 赵国栋[3] 许勇[3] 许大彬[3] 薛瑞华[3] 刘荣[3] 

机构地区：[1]海军总医院急诊科,北京100048 [2]解放军医学院研究生队,北京100853 [3]解放军总医院肿瘤外二科,北京100853

出　　处：《中华腔镜外科杂志（电子版）》2015年第3期1-5,共5页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的总结并阐述三步法断肝作为完全腹腔镜左半肝切除的标准化手术方法和步骤,评估其在治疗肝良性、恶性疾病中的应用价值。方法应用三步法断肝完成完全腹腔镜左半肝切除:左肝蒂的离断、肝实质的离断、肝静脉的离断。通过手术时间、术中出血量、术后住院天数、术后并发症、90 d手术病死率等指标,进行短期疗效评价。结果 2013年1月至2014年12月共17例患者接受腹腔镜左半肝切除手术,全部采用三步法断肝,平均手术时间(166.7±51.5)min,平均术中出血量(152.4±91.4)ml,平均术后住院时间(6.3±2.2)d,无中转开腹,90 d手术病死率为零。结论通过三步法断肝,可以安全有效地完成完全腹腔镜左半肝切除手术。Objective To summarize and elaborate the Three-step liver resection approach as a standardized procedure of totally laparoscopic left hemihepatectomy（ LLH） and evaluate its application value of benign and malignant liver diseases therapy. Methods A Three-step liver resection approach of totally LLH was carried out which contained three major steps： division of the left hepatic pedicle,transection of liver parenchyma and division of the left hepatic vein. Data of short-term outcomes,such as operative time,estimated intraoperative blood loss,length of postoperative hospital stay,complication and 90 day mortality were recorded and analyzed for efficacy evaluation. Results A total of 17 patients were underwent totally LLH with a Three-step liver resection approach between Jan. 2013 and Dec. 2014 The mean operative time was（ 166. 7 ± 51. 5） min,mean blood loss was（ 152. 4 ± 91. 4） ml and the mean length of hospital stay was（ 6. 3 ± 2. 2） days. No conversion was observed and the 90 day mortality was zero. Conclusions Totally LLH with Three-step liver resection approach are practicable,safe and effective.

关 键 词：腹腔镜 肝切除术 腹腔镜肝切除手术 大范围腹腔镜肝切除手术 微创外科 

分 类 号：R657.3[医药卫生—外科学]