腹腔镜解剖性半肝切除术技巧及关键技术  

Skills and key technical difficulties of laparoscopic anatomical hemihepatectomy

作　　者：尹新民[1] 朱斯维[1] 

机构地区：[1]湖南省人民医院肝胆微创外科,湖南长沙410005

出　　处：《中国实用外科杂志》2017年第5期477-481,共5页Chinese Journal of Practical Surgery

摘　　要：腹腔镜半肝切除术是腹腔镜肝切除术的代表性手术之一。随着腹腔镜手术技术和器械的进步,实现更高质量的解剖性肝切除是对腹腔镜外科医生的时代要求。腹腔镜解剖性半肝切除术(LAHH)必须遵循开腹手术的质量标准,严格掌握手术适应证。良好的团队、技术和器械储备是开展LAHH的前提,体位与戳孔设置、入肝血流阻断、肝实质离断、腹腔与静脉压力设定是成功实施LAHH不可或缺的步骤和细节。肝中静脉的定位与显露、术中出血的控制与处理是LAHH的关键环节。Laparoscopic hemihepatectomy is one of the representative procedures of laparoscopic hepatectomy. With the development of laparoscopic techniques and instruments, it is an urgent requirement of time for laparoscopic doctors to achieve higher quality anatomical liver resection. Laparoscopic anatomical hemihepateetomy （LAHI4） must follow the quality standard of open surgery, strictly follow the indications of surgery. Good team, technology and equipment reserve are the premise to carry out LAHH. Patient position, troear setting, blood blocking of inflow, liver parenchyma cutting, pneumoperitoneum and vein pressure setting are steps and details constitute a successful LAHH indispensable. The localization and exposure of the middle hepatic vein, the control and management of intraoperative hemorrhage are the keys of LAHH.

关 键 词：腹腔镜 肝切除术 解剖性半肝切除 肝中静脉 

分 类 号：R6[医药卫生—外科学]