无血流阻断的腹腔镜肝右后叶血管瘤切除28例临床分析  

Laparoscopic resection of hemangiomas in the right posterior hepatic section without any blood flow occlusion: a study on 28 patients

作　　者：汪建初[1] 姚天尉 罗宗将 张英[2] 汪伟 陈鹏宇 陆礼柏 路远[1] 李文川[1] 浦涧[1] Wang Jianchu;Yao Tianwei;Luo Zongjiang;Zhang Ying;Wang Wei;Chen Pengyu;Lu Libai;Lu Yuan;Li Wenchuan;Pu Jian(Department of Hepatobiliary Surgery,Affiliated Hospital of Youjiang Medical College for Nationalities,Baise 533000,Guangxi,China;Library of Youjiang Medical College for Nationalities,Baise 533000,Guangxi,China)

机构地区：[1]右江民族医学院附属医院肝胆外科,广西百色533000 [2]右江民族医学院图书馆,广西百色533000

出　　处：《中华肝胆外科杂志》2019年第6期415-417,共3页Chinese Journal of Hepatobiliary Surgery

基　　金：广西重大科技创新基地(医学中心类)项目(AD17129025).

摘　　要：目的分析无血流阻断的腹腔镜肝右后叶血管瘤切除的疗效和安全性。方法回顾分析右江民族医学院附属医院2016年1月至2018年6月28例肝右后叶血管瘤患者资料,其中女性19例,男性9例,年龄(37.9±6.1)。记录和分析手术情况、围手术期指标、住院费用、随访情况等。结果28例肝右后叶血管瘤患者均行无血流阻断的腹腔镜切除手术,其中27例仅使用超声刀断肝,1例应用超声刀和血管闭合系统联合断肝。瘤体直径(6.7±1.3)cm。术中出血量(330.4±139.0)ml,手术时间(87.4±27.9)min。1例因术中瘤体破裂出血而中转开腹,中转开腹率3.6%(1/28)。术后引流管放置时间(45.4±18.9)h,术后住院时间(7.5±1.3)d,住院费用(3.1±0.5)万元。无死亡及严重并发症发生,无非计划再次手术。术后随访1~30个月,随访期间均无明显不适。结论无血流阻断的腹腔镜肝右后叶血管瘤切除术安全且效果确切,可以为腹腔镜肝右后叶血管瘤切除提供参考。Objective To study the safety and efficacy of laparoscopic resection of hemangioma in the right posterior hepatic section without any blood flow occlusion. Methods Patients with hemangiomas in the right posterior section of liver operated from January 2016 to June 2018 in the Affiliated Hospital of Youjiang Medical College for Nationalities were studied retrospectively. There were 19 females and 9 males. The average age was (37.9±6.1). The operation methods, perioperative factors, hospitalization cost and follow-up outcomes were recorded and analyzed. Results 28 patients with hemangiomas were treated with laparoscopic resection of right posterior hepatic section without any blood flow occlusion. An ultrasound scalpel was applied to split the liver in 27 patients, and ultrasound scalpel combined with Ligasure to split the liver in 1 patient. The mean diameter of the hepatic hemangiomas was (6.7±1.3) cm. The intraoperative blood loss was (330.4±139.0) ml and the operation time was (87.4±27.9) min. One patient required conversion to open surgery due to rupture and bleeding of the hemangioma. The conversion rate was 3.6%(1/28). The postoperative drainage time was (45.4±18.9) h. The postoperative hospitalization time was (7.5±1.3) d, and the hospitalization cost was (3.1±0.5) ten thousand yuan. No death or serious complications occurred. No reoperation was needed. The follow-up period ranged from 1 to 30 months, and all the patients were well on follow-up. Conclusions Laparoscopic resection of hemangioma in the right posterior hepatic section without any blood flow occlusion was safe and efficacious. This method can be used for hemangiomas in the right posterior section of liver.

关 键 词：血管瘤 肝 腹腔镜 无血流阻断 

分 类 号：R735.7[医药卫生—肿瘤]