电视腹腔镜肝切除15例报告  

Laparoscopic liver resection in 15 patients

作　　者：李朝龙[1] 方学军[1] 林建华[1] 于晓园[1] 邹衍泰[1] 李晓平[1] 李春芳[1] 

机构地区：[1]第一军医大学南方医院肝胆血管外科,广州市510515

出　　处：《中华肝胆外科杂志》2003年第9期533-534,共2页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　探讨腹腔镜下肝切除术。方法　位于肝第Ⅱ、Ⅲ、Ⅳa、Ⅴ、Ⅵ段 ,直径 <10cm的9例原发性肝癌 ,4例肝海绵状血管瘤 ,2例肝局限性增生结节病人 ,在全气腹状态、气腹结合免气腹或腹腔镜加小切口下 ,采用 (1)缝扎切开 ;(2 )钳夹电凝断肝 ;(3)微波固化后断肝 ;(4 )旋吸断肝 ;(5 )超声刀断肝 ;(6 )切割缝合器断肝 ;(7)常规器械切肝多种断肝方法行腹腔镜肝切除术。结果　 15例腹腔镜肝切除均获得成功 ,手术时间 1 5～ 8h ,术中出血 5 0～ 5 0 0ml。术后恢复顺利 ,除 1例胆漏外 ,无其他并发症 ,住院时间为 5～ 4 0d。结论　位于肝第Ⅱ、Ⅲ、Ⅳa、Ⅴ、Ⅵ段 ,直径不超过 10cm ,无周围脏器浸润的肝肿瘤病人行腹腔镜肝切除术是安全可行的。Objective To study laparoscopic liver resection. Methods A total of 15 patients were included in this study. Of the 15 patients, 9 were with liver cancer, 4 with liver spongy hemangioma and 2 with local hyperplasitic node. The tumors with a diameter ranging from 3 cm to 10 cm were located in segment Ⅱ,Ⅲ,Ⅳa,Ⅴ and Ⅵ, respectively. The liver tumors were laparoscopically resected under pneumoperitoneum, pneumoperitoneum in combination with non-pneumoperitoneum or with the assistance of short abdominal incision. Many methods such as suture ligation, clamping coagulation, microwave coagulation, rotation and suction, ultrasonic dissection, ENDOGIA ligation and the usual dissection etc. were used to dissect the liver tissue. Results The operation was successfully performed in all the 15 patients. The operative time was 1.5-8 h and blood loss 50-500 ml. The postoperative recovery was smooth and good except that 1 patient had a complication of bile leakage. The duration for hospitalization was 5-40 d. Conclusions Laparoscopic liver resection is safe and feasible for the liver tumors with a diameter less than 10 cm in segment Ⅱ,Ⅲ,Ⅳa,Ⅴ and Ⅵ that do not invade the surrounding viscera.

关 键 词：电视腹腔镜 肝切除术 肝癌 手术治疗 

分 类 号：R657.3[医药卫生—外科学]