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作 者:黄靖波 刘亚晖 李智[1] 申瑶 段小辉 毛先海[1] Huang Jingbo;Liu Yahui;Li Zhi;Shen Yao;Duan Xiaohui;Mao Xianhai(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Hunan Normal University(Hunan Provincial People's Hospital),Changsha 410005,China)
机构地区:[1]湖南师范大学附属第一医院(湖南省人民医院)肝胆外科,长沙410005
出 处:《中华肝胆外科杂志》2022年第3期198-201,共4页Chinese Journal of Hepatobiliary Surgery
基 金:湖南省教育厅科学研究优青项目(20B354);湖南省肝胆胰肠疑难病诊治中心项目。
摘 要:目的探讨肝中静脉尾侧入路腹背侧联合显露在肝癌腹腔镜解剖性半肝切除术(LAHH)中应用的可行性。方法回顾性分析2021年1月至9月湖南师范大学附属第一医院(湖南省人民医院)肝胆外科44例肝癌行尾侧入路腹背侧联合显露肝中静脉的LAHH患者临床资料,其中男性24例,女性20例,年龄(61±5)岁,年龄范围56~66岁。分析患者手术时间、术中出血量、第一肝门阻断时间、术后并发症、术后住院时间等。结果44例患者均顺利完成手术。手术时间(259.3±33.4)min。术中出血量(113.8±31.0)ml,无术中输血。术中第一肝门阻断时间(56.1±7.1)min。术后无出血、胆漏等并发症发生。术后住院时间(9.3±1.4)d。术后病理证实肝细胞癌36例,肝内胆管细胞癌8例。结论在肝癌LAHH中,经尾侧入路腹背侧联合显露肝中静脉有利于更好地显露肝中静脉,减少术中意外出血,保障手术安全。Objective To investigate the feasibility of ventral-combined-dorsal exposure of middle hepatic vein via caudal approach in laparoscopic anatomic hemihepatectomy of liver cancer.Methods A retrospective analysis was performed on the clinical data of 44 patients undergoing laparoscopic antecedent hemihepatectomy with the ventral-combined-dorsal exposure of middle hepatic vein via caudal approach in the Department of Hepatobiliary Surgery,the First Affiliated Hospital of Hunan Normal University(Hunan Provincial People's Hospital)from January 2021 to September 2021.Among the 44 patients,there were 24 male and 20 female patients,aged 56-66(61±5)years.The operative time,intraoperative blood loss,occlusion time of the first hilum hepatis,postoperative complications and postoperative hospital stay were analyzed.Results All 44 patients underwent the surgery successfully.The average operation time was(259.3±33.4)min.Intraoperative blood loss was(113.8±31.0)ml,and no intraoperative blood transfusion was performed.The mean intraoperative occlusion time of the first hilum was(56.1±7.1)min.No postoperative hemorrhage and biliary fistula and other complications occurred.The mean postoperative hospital stay is(9.3±1.4)days.Pathological examination confirmed hepatocellular carcinoma in 36 cases and intrahepatic cholangiocarcinoma in 8 cases.Conclusion The ventral-combined-dorsal exposure of middle hepatic vein via caudal approach benefits exposure of middle hepatic vein in laparoscopic anatomic hemihepatectomy,reducing intraoperative accidental bleeding and ensuring surgical safety.
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