Glisson蒂横断式腹腔镜肝左外叶切除术临床应用价值  

Clinical application value of laparoscopic left lateral lobectomy using Glissonean pedicle transection

作　　者：陈斯聪 缪丁丁[1] Chen Sicong;Miao Dingding(Department of Hepatobiliary and Pancreatic Surgery,Shenzhen Nanshan People's Hospital,Shenzhen 518052,China)

机构地区：[1]深圳市南山区人民医院肝胆胰腺外科

出　　处：《中华肝脏外科手术学电子杂志》2019年第5期440-443,共4页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：深圳市南山区科技计划区属事业单位研发资助项目(2018077)

摘　　要：目的探讨Glisson蒂横断式腹腔镜肝左外叶切除术的临床应用价值。方法回顾性分析2014年1月至2018年9月在深圳市南山区人民医院行Glisson蒂横断式腹腔镜肝左外叶切除术的34例患者临床资料。其中男10例,女24例;年龄20~72岁,中位年龄52岁。患者均签署知情同意书,符合医学伦理学规定。肝内胆管结石13例,肝血管瘤11例,肝局灶性增生结节4例,肝细胞癌3例,胆管细胞癌1例,转移性肝癌1例,炎性肉芽肿1例。观察患者手术时间、术中出血量、术后并发症等。结果所有患者均顺利完成手术,无中转开腹。平均手术时间(65±13)min,解剖离断Glisson蒂时间2~5 min。术中出血(60±10)ml,术中无输血。术后患者恢复顺利,无胆漏、切口感染、出血等并发症。患者出院后1个月复查,恢复良好,手术切口愈合良好。恶性肿瘤患者术后随访12(3~18)个月,未发现肿瘤复发。结论腹腔镜Glisson蒂横断式肝切除术操作简便,出血少,是安全有效的术式。Objective To investigate the clinical application value of laparoscopic left lateral lobectomy using Glissonean pedicle transection.Methods Clinical data of 34 patients who underwent laparoscopic left lateral lobectomy using Glissonean pedicle transection in Shenzhen Nanshan People's Hospital from January 2014 to September 2018 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among them,10 patients were male and 24 female,aged 20-72 years with a median age of 52 years.13 patients were diagnosed with intrahepatic bile duct stones,11 cases with hepatic hemangioma,4 cases with focal nodular hyperplasia of liver,3 cases with hepatocellular carcinoma,1 case with cholangiocarcinoma,1 case with metastatic liver cancer and 1 case inflammatory granuloma,respectively.The operation time,intraoperative blood loss and postoperative complications were observed.Results All patients completed the operation successfully without conversion to open surgery.The average operation time was(65±13)min,and the dissection time of Glissonean pedicle was 2-5 min.The intraoperative blood loss was(60±10)ml,and no blood transfusion was performed during operation.All the patients recovered well without developing postoperative complications,such as bile leakage,incision infection and hemorrhage,etc.Reexamination at 1 month after discharge showed that the patients recovered well and the incisions were healed well.Patients with malignant tumors were followed up for 12 (3-18) months and no recurrence was observed. Conclusions Laparoscopic leftlateral lobectomy using Glissonean pedicle transection is a safe and effective surgical approach with simpleprocedures and mild bleeding.

关 键 词：腹腔镜 肝切除术 Glisson蒂 

分 类 号：R73[医药卫生—肿瘤]