Glisson系统为中心腹腔镜肝切除临床应用进展  

Application of glisson system centered concept in laparoscopic hepatectomy

作　　者：金浩生 石宁 陈振荣 林叶 JIN Hao-sheng;SHI Ning;CHEN Zhen-rong(不详;Department of General Surgery,Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510080,China)

机构地区：[1]南方医科大学附属广东省人民医院(广东省医学科学院)普通外科,广东广州510080 [2]南方医科大学附属广东省人民医院(广东省医学科学院)广东省心血管病研究所,广东广州510080

出　　处：《中国实用外科杂志》2023年第4期465-469,共5页Chinese Journal of Practical Surgery

基　　金：国家临床重点专科建设项目(No.2022YW030009)。

摘　　要：随着腹腔镜设备和器械的快速进步,以及三维重建、术中超声定位和吲哚菁绿荧光染色实时导航技术的应用,腹腔镜肝切除向精细化和可视化方向发展。同时,以Laennec包膜为代表的肝脏解剖结构的深入研究和肝癌综合转化治疗的蓬勃发展,腹腔镜下肝切除理念也出现了相应改变。Glisson系统为中心肝切除理念完全以病人Glisson蒂个体化解剖特点为依据确定手术方案,术中紧紧围绕病变相关的目标Glisson蒂进行显露、结扎、横断或穿刺,进而完成目标病变的切除,可有效保护正常肝实质的Glisson蒂,保留更多的有效肝实质,为后续的治疗提供保障。With the rapid advancement of laparoscopic equipment and instruments,as well as the application of three-dimensional reconstruction,intraoperative ultrasound positioning and real-time navigation technology of indocyanine green fluorescence staining,laparoscopic liver resection has made rapid progress in the direction of refinement and visualization.At the same time,the in-depth study of liver anatomy represented by the Laennec envelope and the vigorous development of comprehensive conversion therapy for liver cancer have also changed the concept of laparoscopic liver resection.The Glisson system-centered liver resection concept is completely based on the individualized anatomical characteristics of the patient's Glisson pedicle to determine the surgical plan,and the surgical plan is closely related to the lesion-related target Glisson pediment is exposed,ligated,transcribed or punctured,and then the resection of the target lesion is completed,which can effectively protect the normal liver parenchyma of the Grisson ti,retain more effective liver parenchyma,and provide guarantee for subsequent treatment.

关 键 词：Glisson蒂 腹腔镜肝切除 解剖性肝切除 

分 类 号：R6[医药卫生—外科学]