循肝中静脉腹腔镜左半肝切除治疗肝脏良恶性疾病比较分析  

Comparative analysis of laparoscopic left anatomical hemihepatectomy along with middle hepatic vein for benign and malignant liver diseases

作　　者：张新亚 陈邦邦 柴维 张亚军 张浩鹏 王鹏霄 ZHANG Xin-ya;CHENG Bang-bang;CHAI Wei(The Peoples Hospital of Taihe,Fuyang,236000,China)

机构地区：[1]太和县人民医院肝胆外科,阜阳236600

出　　处：《肝胆外科杂志》2021年第6期433-437,共5页Journal of Hepatobiliary Surgery

摘　　要：目的探讨循中肝静脉腹腔镜左半肝切除术的安全性、有效性以及在肝脏良、恶性疾病疗效的差异.方法回顾性分析2017年10月至2020年10月我院开展的腹腔镜下循中肝静脉左半肝切除56例病人临床资料,根据肝脏原发病的性质,分为良性疾病组和恶性疾病组.结果56例患者均在腹腔镜下成功显露肝中静脉主干,顺利完成解剖性左半肝切除术.根据肝脏原发病性质分组,良性疾病组34例包括肝脏海绵状血管瘤13例,肝内外胆管结石21例;恶性疾病组22例包括原发性肝细胞癌16例,转移性肝癌4例,胆管细胞肝癌2例.良性疾病组:男10例,女24例,平均年龄60.64±12.78岁;手术时180.24±25.79min;出血量191.00±17.63ml;平均住院时间为16.12±4.88天;并发症发生率9%(3/34),围手术期死亡0例.恶性疾病组:男12例,女10例,平均年龄61.59±9.20岁;手术时间169.55±24.20min;出血量167.50±16.66ml;平均住院时18.09±4.58天;并发症发生率45%(10/22),围手术期死亡0例.两组比较,良性疾病组术中出血量多于恶性疾病组(户<0.05),术后并发症低于恶性疾病组(P<0.05).结论腹腔镜循肝中静脉左半肝切除术是一种安全的、有效的治疗方法.在肝脏良、恶性疾病中均可获得相似的手术效果.Objective To investigate the safety,effectiveness of laparoscopie left anatomical hemihepatectomy along with middle hepatie vein and the difference between benign and malignant liver diseases.Methods The elinical data of 56 patients who underwent laparoscopic left liver resection along the middle hepatic vein in our hospital from October 2017 to October 2020 were retrospectively analyzed.According to the nature of primary liver disease,the patients were divided into benign disease group and malignant disease group.Result The main trunk of the middle hepatic vein was successfully exposed under laparoscope and anatomic left hepa-tectomy was successfully completed in all 56 patients.The benign disease group included 13 cases of cavernous hemangioma,21 cases of intrahepatic bile duct stones,and 22 cases of malignant disease group included 16 cases of primary liver cancer,4 cases of metastatic liver cancer,and 2 cases of cholangiocarcinoma.In benign disease group,there were 10 males and 24 females,with an average age of 60.64±12.78 years.The operation time was 180.24±25.79min;The blood loss was 191.00±17.63m,and the average hospital stay was 16.12±4.88 days.The complication rate was 9%(3/34).There were 0 deaths during perioperative period.In malignant disease group,there were 12 males and 10 females,with an average age of 61.59±9.20 years.Operation time:169.55±24.20.Min;Blood loss 167.50±16.66ml;The mean length of hospital stay was 18.09±4.58 days;The complication rate was 45%(10/22),and there was no perioperative death.The intraoperative blood loss in benign disease group was higher than that in malignant disease group(P<0.05),and the postoperative complications were lower than that in malignant disease group(P<0.05).Conclusion Laparoscopic left hepatectomy along the middle hepatic vein is a safe and effective treatment.Similar results can be obtained in both benign and malignant liver diseases.

关 键 词：腹腔镜 左半肝切除 肝中静脉 解剖性 

分 类 号：R575[医药卫生—消化系统]