Laennec capsule入路在腹腔镜解剖性肝叶切除术中的应用  

Application of the Laennec capsule approach in laparoscopic anatomical sectionectomy

作　　者：卢鹏 徐伟华 王宏光 Lu Peng;Xu Weihua;Wang Hongguang(Department of Hepatobiliary Surgery,Hainan Hospital of Chinese PLA General Hospital,Sanya 572011,Hainan Province,China;Department of Hepatobiliary Surgery,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]中国人民解放军总医院海南医院肝胆外科,三亚572011 [2]国家癌症中心国家肿瘤临床医学研究中心中国医学科学院北京协和医学院肿瘤医院肝胆外科,100021

出　　处：《中华消化外科杂志》2021年第12期1283-1288,共6页Chinese Journal of Digestive Surgery

基　　金：海南省自然科学基金面上项目(817357);海南省重点研发项目(ZDYF2017134);三亚市医疗卫生科技创新项目(20I6YW13)。

摘　　要：腹腔镜解剖性肝切除术已被临床证实安全、有效,逐渐成为腹腔镜肝切除术的主流手术方式:,笔者通过对Laennec CapsUle重新认识,发现其与肝蒂及肝静脉间存在天然解剖间隙,提示Uemnec capSUle可作为腹腔镜解剖性肝切除术的解剖人路。肝脏的左叶、右前叶、右后叶各有1个独立的肝帝,在不破坏肝实质的則提下可经Laennec capsule人路在肝外行Glisson蒂横断式肝叶切除术。离断平面上肝静脉的显露同样可以经此人路实现,此操作安全、可靠、方便,具有高度可重复性:Laennec capsule人路为腹腔镜解剖性肝叶切除术提供了新思路。Laparoscopic anatomic hepatectomy(LAH)has been widely approved as an essential procedure for safety and availability,and has gradually become the mainstream method of hepatec-tomy.Through a renewed understanding of the Laennec capsule,the authors have found that there exists a natural gap between the Laennec capsule and the adjacent tissues,such as Glisson pedicles and hepatic veins.Consequently,Laennec capsule can serve as the anatomical approach for LAH.The left lobe,right anterior lobe and right posterior lobe has an independent Glisson pedicle respectively,which can be used to perform Glisson pedicle transection sectionectomy via Laennec capsule approach without damaging the liver parenchyma.The exposure of hepatic veins on the detached plane can also be achieved through this approach.Laennec capsule approach provides a new idea for laparoscopic anatomic liver sectionectomy,which is safe,reliable,convenient and highly repeatable.

关 键 词：肝肿瘤 解剖性肝切除术 肝叶切除术 Laennec capsule 肝门板 Glisson蒂 腹腔镜检查 

分 类 号：R657.3[医药卫生—外科学]