腹腔镜肝癌切除术15例报告

Laparoscopic hepatectomy for liver cancer: A report of 15 cases

目的 探讨腹腔镜肝癌切除的可行性与适应证。 方法 1998年 8月～ 2 0 0 4年 9月采用多功能手术解剖器(Peng’smultifunctionaloperativedissector,PMOD)刮吸法断肝技术对 15例肝癌行腹腔镜肝癌切除术。 结果 14例腹腔镜肝癌切除术成功 ,1例因术中出血中转开腹肝癌切除术。腹腔镜肝癌切除术手术时间 6 0～ 2 4 0min ,平均 12 5min。术中出血量 5 0～2 0 0 0ml,平均 5 0 1ml。切除肝脏最大体积 10cm× 9cm× 7cm。术后无并发症发生。术后 2 4h均能下床活动 ,术后 1～ 3d即能进食。术后住院 5～ 10d ,平均 6 5d。 结论 对位于肝脏边缘、右肝表面或左半肝的恶性肿瘤 ,采用PMOD行腹腔镜肝癌切除是可行和安全的。

Objective To evaluate the feasibility and indications of laparoscopic hepatectomy for liver cancer. Methods We used the Peng’s multifunctional operative dissector (PMOD) to perform laparoscopic hepatectomy by using the “curettage and aspiration technique” in 15 cases of primary liver cancer from August 1998 to September 2004. Results Hepatectomy for liver cancer was performed successfully under laparoscope in 14 cases and a conversion to open surgery was required in 1 case because of intra-operative hemorrhage. In laparoscopic hepatectomy, the mean operative time was 125 min(60～240 min), the mean blood loss was 501 ml(50～2 000 ml), and the maximum volume of excised liver was 10 cm×9 cm×7 cm. No postoperative surgical complications were seen. The patients began to ambulate out of the bed 24 hours and to take food 1～3 days after the surgery. The mean length of postoperative hospital stay was 6 5 d(5～10 d). Conclusions Laparoscopic hepatectomy is safe and feasible by using the PMOD for malignant tumors located at the border of the liver, the surface of the right lobe, or the left lobe.