腹腔镜肝切除30例

Laparoscopic hepatectomy: report of 30 cases

目的探讨腹腔镜肝切除的安全性和可行性.方法对病变位于肝脏外周部位(Ⅱ～Ⅵ段)的30例病人,肝细胞癌11例,肝内胆管细胞癌2例,转移性肝癌1例,肝囊腺癌2例,肝血管瘤6例,肝腺瘤2例、肝局灶性结节增生2例,肝内胆管结石4例.采用全气腹下、手助下、辅助下行腹腔镜肝切除术.结果 30例腹腔镜下肝切除均获得成功,肝不规则切除18例,规则性肝叶(段)切除12例,平均手术时间为97 min,平均出血量220 ml,术后无严重并发症发生,术后平均住院日为8 d.结论腹腔镜肝切除是安全可行的,特别是应用手助或辅助肝切除,降低手术难度,有效控制出血,缩短手术时间,是值得选择的微创肝切除方式.

Objective To study the feasibility and safety of laparoscopic hepatectomy. MethodsClinical data of 30 patients undergoing laparoscopic hepatectomy were analyzed. Among 30 patients, hepatocellular carcinoma in was found 11 cases, intrahepatic bile duct carcinoma in 2 cases, metastatic liver carcinoma in one case, hepatic cystdenocarcinoma in 2 cases, hepatic hemangioma in 6 cases, hepatic adenoma in 2 cases, hepatic focal nodular hyperplasia in 2 cases, intrahepatic hepatolithiasis in 4 cases. Results The operation was successful in all 30 patients. Liver procedures included 18 atypical resections and 12 anatomical hepatectomies. Mean operation time was 97 min. Mean blood loss was 220 ml. No serious postoperative complications occurred. The mean postoperative hospital stay was 8 days. Conclusions Laparoscopic resection is feasible, safe for selected patients and laparoscopic hepatectomy minimally invasive and beneficial in method reducing operative difficulty and shortening operative time and applying immediate hemostasis especially for hand-assisted laparoscopic or laparoscopic-assisted hepatectomy.