腹腔镜肝切除术100例手术体会  

Laparoscopic hepatectomy:Experience in 100 cases

作　　者：王冠男 王小明 韩猛 钱道海 王徐 奚士航 潘璇 WANG Guannan;WANG Xiaoming;HAN Meng;QIAN Daohai;WANG Xu;XI Shihang;PAN Xuan(Department of Hepatobiliary Surgery,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,Anhui,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院肝胆外科,安徽芜湖241001

出　　处：《皖南医学院学报》2024年第1期45-48,共4页Journal of Wannan Medical College

基　　金：安徽省高校优秀拔尖人才培育资助项目(gxbjZD17);皖南医学院重点项目科研基金(WK2022ZF14);弋矶山医院三新项目(Z1906)。

摘　　要：目的:分析非血流阻断下腹腔镜肝切除的疗效和安全性。方法:回顾性分析弋矶山医院2016~2021年100例采用腹腔镜肝切除术的肝脏病变患者资料,阻断组采用肝门血流阻断,非阻断组未进行肝门血流阻断。记录手术时间、术中出血量、围手术期相关生化指标等。结果:100例患者均顺利完成手术,无中转开腹手术。阻断组术中出血量少于非阻断组(P<0.05),术后转氨酶水平高于非阻断组(P<0.05)。术后3例发生胆漏,经冲洗引流后治愈,顺利出院。无围手术期死亡及严重并发症发生,无非计划再次手术。术后随访6~12个月,肿瘤患者无局部复发及远处转移。结论:对于合适的患者,非血流阻断的腹腔镜肝切除术,可以减少因肝门阻断对术后肝功能的影响,手术安全、可行。Objective:To investigate the efficacy and safety of laparoscopic liver resection(LLR)without portal occlusion.Methods:Respective analysis was performed in 100 cases of liver tumor undergone LLR in our hospital between 2016 and 2021.The patients were divided into portal occlusion group(treated with portal occlusion),and non-portal occlusion group(without portal occlusion).The data,including operative time,intraoperative blood loss and perioperative biochemical indicators,were recorded and analyzed in the two groups.Results:LLR was successfully completed in the 100 patients without conversion to open surgery.Patients in the portal occlusion group had lower intraoperative blood loss and higher postoperative transaminase level than those in non-portal occlusion group(P<0.05).Bile leakage occurred in 3 cases after operation,and was managed by peritoneal lavage and drainage.No perioperative death or severe complications occurred,and there was no incidence of unplanned reoperation.All patients were safely discharged,and subjected to follow-up for 6 to 12 months,which showed no recurrence and distant metastasis.Conclusion:Laparoscopic liver resection without portal occlusion can be safe and feasible in eligible patients,and reduce the effect of hepatic portal occlusion on postoperative liver function.

关 键 词：腹腔镜肝切除 非血流阻断 循肝蒂入路 

分 类 号：R657.3[医药卫生—外科学]