腹腔镜解剖性肝切除术临床分析  

Clinical analysis laparoscopic anatomical hepatectomy

作　　者：王文斌[1] 闫长青[1] 吕海涛[1] 张建生[1] 边伟[1] 刘润田[1] 刘学青[1] 刘建华[1] 

机构地区：[1]河北医科大学第二医院肝胆外科,石家庄050017

出　　处：《中华肝胆外科杂志》2016年第1期9-12,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨腹腔镜解剖性肝切除术的技术要点和手术疗效。方法回顾2013年10月至2015年5月河北医科大学第二医院肝胆外科60例腹腔镜下肝切除术患者临床资料。结果60例患者中转开腹手术2例，其余均顺利完成腹腔镜下肝切除术。行规则性肝叶（段）切除术者40例，其中6例为右半肝切除，10例为左半肝切除，2例为尾状叶切除，2例为右后叶切除，15例为左外叶切除，3例为V段切除，2例为Ⅵ段切除；另外20例为不规则肝部分切除。平均手术时间（210±20）min，术中出血量（320±140）ml，平均住院时间（10±2）d。无手术死亡及严重并发症发生。所有患者均于术后1—3天内恢复进食。50例术后随访1～19个月。在获得随访的36例恶性肿瘤患者中（包括3例转移癌），有3例原发肝癌术后复发转移，其余患者均无复发。结论腹腔镜解剖性肝切除术能安全用于肝段及半肝切除，有望成为临床常规手术。Objective To evaluate the feasibility and efficacy of laparoscopic anatomical hepatectomy. Methods The clinical data of 60 patients who underwent laparoscopic hepatectomy from October 2013 to May 2015 were retrospectively analyzed. Results Two patients required conversion to laparotomy. Laparoseopic an- atomical hepatectomy was carried out in 40 patients, including 6 with right hemihepatectomy, 10 with left hemi- hepateetomy, 2 with caudate lobe resection, 2 with fight posterior sectioneetomy, 15 with left lateral sectionecto- my, 3 with segment V resection and 2 with segment V[ resection. The other 20 patients had laparoscopic nonan- tomical hepatectomy. The operative time was （210 ~ 20）min, the bleeding volume was （320 ~ 140）ml, and the duration of hospitalization was （ 10 ± 2 ） days. There were no serious postoperative complications. All patients had the first flatus passed between 24 to 72 hours after operation. There was no operative death. On follow-up for 50 patients from 1 to 19 months after surgery, no recurrence was found in 36 malignant liver tumor patients ex- cept in 3 patients who were operated for hepatocellular carcinoma. Conclusion Laparoscopic anatomic hepato- tectomy is a feasible and efficacious option for liver resection to treat liver diseases.

关 键 词：肝切除术 解剖 腹腔镜 

分 类 号：R735.7[医药卫生—肿瘤]