摘要
目的探讨腹腔镜上段胆管癌根治切除术的可行性。方法分别于脐部、右侧上、下腹部及剑突下放置trocar,左上腹部3cm切口用于空肠端侧吻合。切除胆囊及肝左内叶下段的肝组织,切除中上段胆管,肝侧胆管距肿瘤1cm切断。清除肝固有动脉、门静脉周围的纤维脂肪组织及淋巴结。左、右肝管盆式成形,胆肠Roux-en-Y吻合。结果4例胆管肿瘤上端均已达到肝管分叉部,肿瘤直径1～1.5cm。左内叶下段肝组织、中上段胆管的切除及肝门区淋巴结清扫顺利。4例腹腔镜上段胆管癌根治切除手术均获成功。手术时间分别为270、255、270、230min;术中出血量分别为500、400、300、400ml。4例术后病理均为高分化腺癌。例2、3术后出现胆漏,分别于术后20、15d治愈。4例黄疸于术后完全消退,食欲恢复正常,体重分别增加3、3.5、2.2kg。结论应用腹腔镜微创技术可以完成上段胆管癌根治切除时所需切除的胆管肿瘤,部分肝组织,清扫肝门区纤维脂肪组织及淋巴结,腹腔镜下完成胆道重建。腹腔镜上段胆管癌根治切除术是可行的。
Objective To evaluate the feasibility of laparoscopic cholangiotomy for radical excision of upper cholangiocarcinoma. Methods Four trocars were placed at the umbilical area, right upper and lower abdomen, and below the xiphoid. A 3 cm incision was made at the left upper abdomen for Roux-en-Y jejunojejunostomy. The gallbladder, inferior segment of the left medial liver, and the middle-upper segment of the bile duct were resected. And then the tumor and the adjacent 1 cm bile duct were excised. Afterwards, th...
出处
《中国微创外科杂志》
CSCD
2008年第1期31-34,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
腹腔镜
上段胆管癌
根治术
Laparoscopy
Upper cholangiocarcinoma
Radical excision
