区域性血流阻断技术在腹腔镜肝切除术中的应用

The application of selective portal inflow occlusion in laparoscopic hepatectomy

目的探讨腹腔镜区域性血流阻断技术的安全性和可行性。方法 2005年1月—2006年2月,对7例肝脏病变患者施行腹腔镜区域性血流阻断肝切除术,男1例,女6例,年龄31～70岁,平均48.9岁。手术方式包括左肝外叶切除4例、左半肝切除2例、右半肝切除1例。采用冲吸钝性解剖法显露门静脉、肝动脉及其分支,并用可吸收夹夹闭,完成区域性血流阻断。结果 7例均成功完成区域性血流阻断,无中转开腹,无死亡,无并发症。平均手术时间188.7 min(70～300 min),平均术中出血量625 ml(350～1000 ml),平均术后住院8.4 d。结论腹腔镜区域性血流阻断技术是安全可行的。

Objective To discuss the safety and the feasibility of laparoscopic selective portal inflow occlusion. Methods From January ：2005 to February 2006, 7 patients were performed by laparoscopic hepatectomy with selective portal inflow occlusion. The patients included 1 male and 6 females, the mean age was 48. 9 years, ranged from 31 to 70 years. Procedure included left lateral segmentectomies （4 patients）, left hemihepatectomies（2 patients）, and right hemihepatectomies （1 patient）. Portal vein, hepatic artery and their branches were exposed by blunt dissection and performed selective portal occlusion with absorbable clips. Results There is no conversion, no mortality, and no postoperative complication. Seven selective portal inflow occlusions were performed successfully. The mean operating time was 188.7 min （range 70 min to 300 min） , the mean intraoperative blood loss was 625 ml （range 350 ml to 1000 ml） , and the mean postoperative hospital stay was 8.4 days. Conclusions Laparoscopic selective portal inflow occlusion is a safe and feasible technique.