改良腹腔镜肝右后叶血管瘤切除35例报告  

Modified laparoscopic resection for hemangioma in the right posterior liver section： a report of 35 cases

作　　者：靳斌[1] 周兵海 杜刚[1] 刘炎锋[1] 唐振宇[1] 黄国振[1] 韩立涛[1] 刘泽阳[1] 李佳[1] 张士哲 付志浩[1] 胡三元[1] 

机构地区：[1]山东省山东大学齐鲁医院普外科,济南250012

出　　处：《中华肝胆外科杂志》2015年第11期726-728,共3页Chinese Journal of Hepatobiliary Surgery

基　　金：国家科学自然基金（81571367）;山东大学基础科研项目（2014QLKY18）

摘　　要：目的探讨改良腹腔镜肝右后叶血管瘤切除的可行性、安全性。方法回顾性分析齐鲁医院2012年11月至2015年3月35例肝右后叶血管瘤患者行改良腹腔镜肝切除的临床资料。35例患者术前均经影像学（腹部超声、计算机化断层显像及强化CT、核磁共振显像）诊断为肝右后叶血管瘤，所有患者凝血功能、肝功能及AFP均正常。结果35例肝切除手术全部在腹腔镜下完成，无一中转开腹。术中28例需要阻断肝门，平均阻断时间为（21．2±6．2）min。手术平均时间为（143．4±24．0）min，术中出血平均为（168．0±143．2）ml、术中及术后均未输血。术后平均住院（10．4±2．2）d，引流管平均留置时间为（5．4±1．1）d。术后无大出血等严重并发症发生，30及90天病死率为0。结论肝右后叶血管瘤位置靠后，行腹腔镜肝血管瘤切除术较困难。采用我科改良的腹腔镜方法行腹腔镜肝右后叶血管瘤切除术安全、可行。Objective To study the feasibility and safety of modified laparoscopie liver resection for hemangioma in the right posterior liver section. Methods Between November 2012 and March 2015, a retrospective study was carried out on 35 patients with hepatic hemangioma in the right posterior liver section diagnosed on preoperative abdominal ultrasound, computed tomography and/or magnetic resonance imaging, and received modified laparoscopic liver resection. These patients had good liver function, coagulation function and normal level of α-fetoprotein. Results Modified laparoseopic liver resection of hemangiomas in the hepatic right poste- rior section was performed successfully. No patients had to be converted to open surgery. In 28 patients, portal triad clamping with a mean clamp time of （21.2 ± 6. 2 ） min was required. The mean operating time was （143.4 ±24. 0） min. The mean amount of bleeding was （168.0 ± 143.2） ml. No blood transfusion was re- quired in these patients during the intra-operative and post-operative periods. The mean length of hospital stay was （ 10, 4 ±2.2） days and the mean duration of abdominal drainage was （5.4 ±1.1 ） days, No patients deve- loped severe complications. The 30-day mortality and the 90-day mortality were both 0. Conclusions Laparoscopic hepatectomy for hemangioma in the right posterior liver section was difficult because of deep location of the lesions which had a tendency to bleed. We successfully performed laparoscopic liver resection in these patients usinz our modified surzieal techniuues which have been found to be safe and feasible.

关 键 词：腹腔镜 血管瘤 肝右后叶 手术 改良 

分 类 号：R758.51[医药卫生—皮肤病学与性病学]