左侧卧60°跑步-拥抱位在腹腔镜肝右后叶切除术中的应用分析  

Analysis of clinical application of laparoscopic right posterior sectionectomy with the left side lying at 60°run-hug position

作　　者：朱常琰 胡玉秋 李德清 段金鑫 林鸿操 陈光耀 周泉波 付志强 Zhu Changyan;Hu Yuqiu;Li Deqing;Duan Jinxin;Lin Hongcao;Chen Guangyao;Zhou Quanbo;Fu Zhiqiang(Department of Biliary and Pancreatic Surgery,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;Department of Breast Surgery,the Eighth Affiliated Hospital,Sun Yat-sen University,Shenzhen 518033,China;Department of Hepatobiliary and Pancreatic Surgery,Shenshan Medical Center,Memorial Hospital of Sun Yat-sen University,Shanwei 516621,China;Department of Pancreatic Surgery,Guangdong Provincial Peoples Hospital,Guangzhou 510000,China)

机构地区：[1]中山大学孙逸仙纪念医院胆胰外科,广州510120 [2]中山大学附属第八医院(深圳福田)乳腺外科,深圳518033 [3]中山大学孙逸仙纪念医院深汕中心医院肝胆胰外科,汕尾516621 [4]广东省人民医院胰腺外科,广州510000

出　　处：《中华肝胆外科杂志》2024年第7期489-493,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：广东省基础与应用基础研究基金(2019A1515011217)。

摘　　要：目的分析左侧卧60°跑步-拥抱位应用于腹腔镜肝右后叶切除术的安全性及有效性。方法回顾性分析2022年8月至2023年6月于中山大学孙逸仙纪念医院胆胰外科接受左侧卧60°跑步-拥抱位腹腔镜肝右后叶切除术的12例患者的临床资料,其中男性9例,女性3例,年龄范围26~76岁,中位年龄52.5岁。总结手术时间、术中出血量、术中肝门阻断次数和时间、术后引流时间、术后住院时间、术后并发症等指标,评估手术的安全性和有效性。结果12例患者均在腹腔镜下顺利完成手术,无患者因术中出血难以控制而被迫中转开腹。12例患者包括肝内胆管结石1例、原发性肝癌5例、肝血管瘤2例、肝脏局灶性结节性增生2例、转移性肝癌1例、肝脓肿1例。12例患者手术时间为(246.2±90.4)min,术中出血量为125(22,275)ml,术中肝门阻断次数2.00(0.25,2.75)次,术中肝门阻断时间为(27±22)min,术后引流时间为(5.0±2.6)d,术后住院时间为6.0(4.3,8.0)d。术中输血1例,术后出现腹腔积液1例。无围手术期死亡,所有患者均顺利出院。结论对于肝右后叶区域的病灶,采用左侧卧60°跑步-拥抱位行腹腔镜肝右后叶切除术是安全且有效的。ObjectiveTo explore the safety and efficacy of laparoscopic right posterior sectionectomy(LRPS)in the left side lying at 60°run-hug position.MethodsThe clinical data of 12 cases underwent LRPS at the Department of Biliary and Pancreatic Surgery,Sun Yat-sen Memorial Hospital,Sun Yat-sen University from August 2022 to June 2023 were analyzed.There were 9 males and 3 females,ranging in age from 26 to 76 years old.To evaluate the safety and effectiveness of the operation,operation time,intraoperative blood loss,the number and time of intraoperative hilar occlusion,postoperative drainage time,postoperative hospitalization time and postoperative complications were summarized.ResultsTwelve operations were successfully completed under laparoscopy,and no patient was converted to laparotomy due to the difficulty in controlling intraoperative bleeding.12 patients included 1 case of intrahepatic bile duct stones,5 cases of primary liver cancer,2 cases of hepatic hemangioma,2 cases of focal nodular hyperplasia of the liver,1 case of metastatic liver cancer,and 1 case of liver abscess.Operation time was(246.2±90.4)min,and the intraoperative blood loss was 125(22,275)ml.The number of intraoperative hilar occlusion was 2.00(0.25,2.75),and intraoperative hilar occlusion time was(27±22)min.Postoperative drainage time was(5.0±2.6)d,and the length of postoperative hospital stay was 6.0(4.3,8.0)d.Intraoperative blood transfusion occurred in 1 patient,and postoperative abdominal effusion occurred in 1 patient.There was no postoperative death.All patients were recovered and discharged successfully.ConclusionLRPS is safe and effective for the lesions in the right posterior hepatic region with the left side lying at 60°run-hug position.

关 键 词：腹腔镜 肝切除术 左侧卧60°跑步-拥抱位 应用分析 

分 类 号：R657.3[医药卫生—外科学]