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目的探讨腹腔镜下肝部分切除术的方法和临床应用,总结手术经验。方法回顾分析吉林大学白求恩第一医院自2008年1月至2011年11月期间经临床筛选的位于肝脏左外叶及Ⅵ肝段适合行腹腔镜手术的肝脏肿瘤患者30例,其中男性17例,女性13例;年龄24～68岁,平均年龄41岁。所有患者行腹腔镜肝部分切除术。结果30例患者均成功地在腹腔镜下施行了肝部分切除术,无中转开腹及延长腹壁小切口,手术时间30～60 min,平均手术时间52 min。术中出血量20～200 mL,平均出血量110 mL。术后住院时间4～8 d,平均住院时间6 d。术后未发现并发症。术后病理组织检查证实23例肝细胞癌,7例肝脏血管瘤。结论经过临床选择的病例,腹腔镜肝部分切除术是安全可靠的微创方法,对肝脏边缘型小病灶行完全腹腔镜下病灶切除更具微创意义。
Objective To explore the method and clinical application of laparoscopic partial hepatectomy and summarize the surgical experience. Methods The retrospective analysis of 30 cases of liver tumors in the left external lobe of the liver and VI segment suitable for laparoscopic surgery from January 2008 to November 2011 in the Bethune First Hospital of Jilin University, including 17 males, There were 13 females; aged 24-68 years and mean age 41 years. All patients underwent laparoscopic partial hepatectomy. Results All the 30 patients underwent laparoscopic partial hepatectomy successfully. No laparotomy or prolonged abdominal incision was performed. The operation time was 30-60 min and the average operation time was 52 min. Intraoperative blood loss was 20 to 200 mL and the average blood loss was 110 mL. Postoperative hospital stay was 4-8 days and the average length of stay was 6 days. No complications were found after surgery. Postoperative pathological examination confirmed 23 cases of hepatocellular carcinoma and 7 cases of hepatic hemangiomas. Conclusion After clinically selected cases, laparoscopic partial hepatectomy is a safe and reliable method for minimally invasive surgery. It is more minimally invasive for complete laparoscopic resection of marginal small lesions of the liver.