腹腔镜肝切除术中血管重建技术进展  

Advances in vascular reconstruction techniques in laparoscopic hepatectomy

作　　者：李中宇 麻勇[1] LI Zhong-yu;MA Yong(Department of Minimal Invasive Hepatic Surgery,The First Affiliated Hospi-tal of Harbin Medical University,Key Laboratory of Hepato-splenic Surgery,Ministry of Education,Heilongjiang Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院肝脏微创外科,省部共建教育部肝脾外科重点实验室,黑龙江哈尔滨150001

出　　处：《中国实用外科杂志》2022年第9期1051-1053,共3页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金(No.81100305,No.81470876);黑龙江省自然科学科学基金(No.LC2018037);博士后研究人员落户黑龙江科研启动资助金(No.LBH-Q17097)。

摘　　要：随着微创外科诊疗技术的不断发展,腹腔镜肝切除术凭借其创伤小、疼痛轻、恢复快等诸多的优越性,逐渐成为治疗肝脏相关肿瘤的首选治疗方式。肝切除术中保护肝脏的血液供应及回流将影响病人的预后,因此,血管重建技术作为肝移植手术的重要技术手段,在腹腔镜肝切除术中也逐渐得到广泛应用。腹腔镜肝切除术中主要涉及肝动脉、肝静脉、门静脉和下腔静脉的重建。血管重建的方式主要包括:血管缺损的缝合,断端的端对端吻合,自体腹膜补片或聚四氟乙烯补片修补,自体血管、冻存的同源血管或人工血管替代等方式。根据病人不同的情况选择适合的血管重建方式也尤为重要。With the continuous development of minimally invasive surgical diagnosis and treatment technology,laparoscopic hepatectomy has gradually become the preferred treatment for liver-related tumors due to its advantages of less injury,less pain,and faster recovery.Protecting the blood supply and backflow of the liver during hepatectomy will affect the prognosis of patients.Therefore,as an important technical means of liver transplantation,vascular reconstruction technology has gradually been widely used in laparoscopic hepatectomy.Laparoscopic hepatectomy mainly involves reconstruction of the hepatic artery,hepatic vein,portal vein and inferior vena cava.The methods of vascular reconstruction mainly include:suture of vascular defects,end-to-end anastomosis of broken ends,repair of autologous peritoneal patch or polytetrafluoroethylene patch,replacement of autologous blood vessels,cryopreserved homologous blood vessels or artificial blood vessels.It is also particularly important to select the appropriate vascular reconstruction method according to the individual conditions of each patient.

关 键 词：腹腔镜肝切除术 血管重建 血管移植 人工血管 

分 类 号：R6[医药卫生—外科学]