腹腔镜下Glisson蒂横断法肝段切除策略  

Glisson pedicle transaction method for laparoscopic hepatectomy

作　　者：王超[1] 余德才[1] 吴星宇[1] 孙喜太[1] 

机构地区：[1]南京大学医学院附属鼓楼医院肝胆外科,210000

出　　处：《中华普外科手术学杂志（电子版）》2017年第5期380-382,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：国家自然科学基金面上项目(81372455)~~

摘　　要：目的探讨腹腔镜下Glisson蒂横断法肝切除术的可行性和技术要点。方法回顾性分析2015年5月至2016年11月期间实施腹腔镜下Glisson蒂横断法肝切除术共23例。详细描述从Ⅱ段到Ⅷ段肝切除的技术要点,并观察手术时间,术中出血量,住院时间,术后并发症,近期疗效的指标。结果 23例患者接受腹腔镜下Glisson蒂横断法肝切除,其中Ⅱ、Ⅲ、Ⅴ、Ⅵ、Ⅶ段肝切除各2例、左半肝切除3例、右半肝切除3例、左外叶5例、右后叶2例。主要技术要点均为肝门部肝蒂解剖。手术均获得成功,没有中转开腹病例。平均手术时间[195.4±135.4(45~300)]min,术中平均出血量[216.7±89.4(150~300)]ml,均无输血,术后平均住院时间[5.0±1.6(3~7)]d,无手术并发症,随访早期无肿瘤复发和转移。结论腹腔镜下Glisson蒂横断法肝切除术安全可行,具有手术时间短,创伤小等优点,可在很大程度上简化了腹腔镜肝段切除。Objective To evaluate the feasibility and technique of Glisson pedicle transaction method for laparoscopic hepatectomy . Methods Between May 2015 and November 2016, 23 cases undergoing laparoscopic hepatectomy using the Glisson pedicle transaction method at the Drum Tower hospital were analyzed.And the operation time, intraoperation bleeding, postoperation hospitalization, complication incidences and short and long team survival outcomes were observed . Results Among the 23 cases undergoing laparoscopic hepatectomy , there were 2 cases with segment Ⅱ hepatectomy, 2 cases with segmentⅢ hepatectomy, 2 cases with segment Ⅴ hepatectomy, 2 cases with segment Ⅵ hepatectomy, 2 cases with segment Ⅶ hepatectomy, respectively, 3 cases with left hemihepatectomy , 3 cases with right hemihepatectomy, 5 cases with left lateral segment hepatectomy , 2 cases with right posterior segment hepatectomy.The main step was dissection of the Glisson capsula at hepatic portal .All the surgeries were successful and no case was converted to open operation ..The average operation time was [195.4 ±135.4 （45 ~300）] min.The average blood loss during operation was [216.7 ±89.4（150 ~300）] ml.The average hospitalization after operation was [5.0 ±1.6 （3 ~7）] d.No complications were found after operation.During the follow-up time, no case with tumour recurrence and metastasis were found . Conclusion The Glisson pedicle transaction method for laparoscopic hepatectomy is feasible and safe with minimal invasive and fast recover, which can simplify the procedure of laparoscopic hepatectomy .

关 键 词：肝切除术 腹腔镜检查 Glisson鞘 

分 类 号：R657.3[医药卫生—外科学]