腹腔镜肝切除手术入路合理选择及评价  

Reasonable selection and appraisal on surgical approach of laparoscopic hepatectomy

作　　者：刘荣[1] 王斐[1] 

机构地区：[1]中国人民解放军总医院全军肝胆外科研究所,肝胆外二科,北京100853

出　　处：《中国实用外科杂志》2017年第5期466-468,共3页Chinese Journal of Practical Surgery

摘　　要：手术入路的研究是实现腹腔镜肝切除术发展成熟的关键性理论基础。肝脏手术入路研究以腹腔镜下处理第一、二肝门为核心技术环节,以减少术中出血和肝脏缺血为主要目标。对门静脉蒂的控制可分为肝门入路、Glisson蒂入路以及裂隙入路3种方式。肝静脉控制方式可以划分为肝实质内途径和肝实质外途径两类。通过合理的肝脏手术入路选择,可以减少术中出血、减小肝血流阻断区域和时间,降低手术难度。The research on surgical approach is the key theoretical basis of the laparoseopie liver resection. The core technology of the liver resection approach is the management of the first and the second porta of liver laparoscopieally, and the main aim is to reduce the blood loss and liver ischemia. There are essentially three approaches for the identification and transection of the portal pedicles： hilar access approach, Glissonean pedicle approach and fissural approach. The identification of the root of hepatic vein could also be divided as intrahepatic and extra hepatic approach. With reasonableapproach selection, the blood loss could be decreased and the operation difficulty could be lowered.

关 键 词：腹腔镜 肝切除术 手术入路 

分 类 号：R6[医药卫生—外科学]