腹腔镜下吸引器刮吸法在肝血管瘤剥除术中的应用体会  

Application of curettage and aspiration dissection technique using aspirator in laparoscopic enucleation of hepatic hemangioma

作　　者：李会星 欧阳才国[1] 吴振宇[1] 秦玉刚[1] 高蔚[1] LI Hui-xing;OUYANG Cai-guo;WU Zhen-yu(Department of Hepatobiliary Surgery,Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院肝胆外科,北京100049

出　　处：《腹腔镜外科杂志》2023年第6期439-443,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜肝血管瘤剥除术的技术要点。方法:回顾分析2016年1月至2022年1月为58例患者行腹腔镜肝血管瘤剥除术的临床资料,统计术中情况、术后并发症及术后恢复情况。结果:54例成功施行完全腹腔镜肝血管瘤剥除术,4例因术中出血较难控制中转开腹,中转率6.9%。手术时间平均(193.6±51.7)min,术中出血量(374.8±241.6)mL。术后平均住院(9.3±2.7)d。5例术后出现轻微胆漏,发生率8.6%;10例并发右侧胸腔积液,发生率17.2%。无术后出血、肝功能衰竭、感染等严重并发症发生。术后患者均痊愈出院,无围手术期死亡病例。结论:腹腔镜下吸引器是剥离肝血管瘤的一件“利”器,沿肝血管瘤壁以吸引器刮吸钝性剥离血管瘤有助于显露保护瘤体周边重要脉管结构,减少术中出血及术后并发症的发生,促进患者术后快速康复。Objective:To explore the technical points of laparoscopic enucleation of hepatic hemangioma.Methods:The clinical data of 58 patients who underwent laparoscopic enucleation of hepatic hemangioma from Jan.2016 to Jan.2022 were retrospectively analyzed.The intraoperative conditions,postoperative complications and postoperative recovery were statistically analyzed.Results:Fifty-four patients successfully underwent totally laparoscopic enucleation of hepatic hemangioma.4 cases were converted to laparotomy which attributed to the intraoperative bleeding was difficult to control.The conversion rate of laparoscopic enucleation to laparotomy was 6.9%.The operation time was(193.6±51.7)min,the intraoperative blood loss was(374.8±241.6)mL,and the postoperative hospital stay was(9.3±2.7)d.5 cases had slight bile leakage after operation with the incidence of 8.6%,and 10 cases were complicated with right pleural effusion with the incidence of 17.2%.There were no severe complications such as postoperative hemorrhage,hepatic failure and infection.All the patients were cured and discharged from the hospital.There were no perioperative deaths.Conclusions:The laparoscopic aspirator is a powerful device for stripping hepatic hemangioma.Curettage and aspiration dissection technique with the aspirator along the wall of hepatic hemangioma is conducive to expose and protection of the important vascular structures around the tumor body.It can reduce the intraoperative blood loss and incidence of postoperative complications,and promote the rapid recovery of patients after surgery.

关 键 词：肝血管瘤 吸引器 腹腔镜检查 剥除术 

分 类 号：R657.3[医药卫生—外科学]