肝实质优先头侧入路显露主肝静脉在腹腔镜解剖性S8切除术中的应用  

Application of the main hepatic vein exposure from the cranial side through preceding liver parenchyma transection approach in laparoscopic anatomical liver resection of S8

作　　者：孙楼宗 王庆大 杨楠[1] SUN Louzong;WANG Qingda;YANG Nan(Department of Hepatobiliary Surgery,Zigong First People's Hospital,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第一人民医院肝胆外科,四川自贡643000

出　　处：《手术电子杂志》2024年第6期17-18,共2页Electronic Journal of Medical Operations

摘　　要：肝癌的主要转移方式是经门静脉肝内转移,因此基于门静脉流域的解剖性肝切除是目前治疗原发性肝癌的经典手术方式。腹腔镜解剖性S8切除术手术难度大,经肝门入路寻找和识别G8肝蒂困难费时,易出现胆漏等并发症,临床推广困难。使用肝实质优先头侧入路显露主肝静脉(MHV、RHV)联合术中超声定位G8根部可更好地引导S5、8段之间断肝平面的把握,降低了腹腔镜解剖性S8切除术的难度,便于临床推广应用。The main pattern of hepatocellular carcinoma metastasis is the intrahepatic metastasis via portal vein,therefore,anatomical liver resection based on portal vein territory is a traditional surgical procedure for hepatocellular carcinoma.Laparoscopic anatomical liver resection of S8 might be a difficult procedure,for the identification and exposure of G 8 by Glissonean approach first(from the hilum)is difficult and time-consuming,associated with a higher incidence of bile leakage,and its clinical application is difficult.Exposure of the main hepatic vein(MHV,RHV)from the cranial side through preceding liver parenchyma transection approach combined with marking of the G8 root using intraoperative ultrasound-guidance can better guide the parenchymal dissection between S 5 and S 8,reduce the difficulty of laparoscopic anatomical liver resection of S 8,and facilitate clinical application and promotion.

关 键 词：腹腔镜 解剖性S8切除术 肝癌 

分 类 号：R735.7[医药卫生—肿瘤]