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目的 探讨腹腔镜肝部分切除术治疗原发性肝癌的方法和应用价值。方法 第Ⅱ、Ⅲ段及Ⅴ、Ⅵ段或边缘型的原发性肝癌9例,在腹腔镜辅助下,应用手助器、超声刀、切割器等特殊器械进行腹腔镜下肝切除术。结果 9例患者均在腹腔镜下完成手术,包括肝Ⅱ、Ⅲ段切除及非规则性肝段切除术,其中2例附加腹腔镜下脾切除术,手术时间80～14 5min ,术后住院6～9d ,手术出血15 0～70 0ml,无中转开腹手术,无并发症。术后随访5～2 5个月,3例分别于手术后3、4及13个月肝内复发,其余6例随访至今无复发。结论 在经过临床选择的病例中,手助腹腔镜下作肝部分切除术治疗原发性肝癌是可行的
Objective To investigate the method and value of laparoscopic partial hepatectomy in the treatment of primary liver cancer. Methods Nine patients with stage Ⅱ, Ⅲ, Ⅴ, Ⅵ, or edge-type primary liver cancer underwent laparoscopic hepatectomy under the help of laparoscope with hand instruments, ultrasonic knives and cutters. Results All the 9 patients underwent laparoscopic surgery, including resection of hepatic segments II and III and hepatic resection of irregular hepatectomy. Among them, 2 patients underwent additional laparoscopic splenectomy, the operative time was 80 to 145 minutes and the postoperative hospital stay was 6 ~ 9d, surgical bleeding 15 0 ~ 70 0ml, no transit laparotomy, no complications. The patients were followed up for 5 to 25 months. Three patients relapsed intrahepaticly at 3, 4, and 13 months after surgery, respectively. The remaining 6 patients were followed up until now. Conclusions Among the clinically selected cases, hand-assisted laparoscopic partial hepatectomy for the treatment of primary liver cancer is feasible