26例手助腹腔镜肝恶性肿瘤切除术

Hand-assisted laparoscopic liver resection for malignant liver neoplasms in 26 cases

目的探讨手助腹腔镜肝恶性肿瘤切除的可行性和安全性。方法对病变位于肝脏外周部位(Ⅱ～Ⅵ段)的26例病人,其中肝细胞癌22例,肝内胆管细胞癌2例,肝囊腺癌1例,直肠癌肝转移1例。采用手助腹腔镜行肝切除术。结果26例手助腹腔镜肝切除均获得成功,规则性肝叶(段)切除17例,肝不规则切除9例,平均手术时间为103min,平均出血182mL,术后无严重并发症发生,术后平均住院9.3d。结论手助腹腔镜肝恶性肿瘤切除是安全可行的,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 assess the feasibility and safety of hand-assisted laparoscopic liver resection for malignant liver neoplasms. [Methods] 26 patients with left-side and fight-peripheral lesion underwent hand-assisted laparoscopic hepatectomy including hepatocellalar carcinoma in 22 cases, intrahepatic bile duct carcinoma in 2 cases, hepatic cystdenocarcinoma in one case, hepatic metastase from rectal carcinoma in One case. 3;he operation was completed by handssisted laparoscopy. [Results] The operation was successful in all 26 patients. Liver procedures included 9 atypical resections and 17 anatomical hepatectomies. Mean surgical time was 103 minutes. Mean blood loss was 182 ml. No serious postoperative complications occurred. The mean postoperative hospital stay was 9.3 days. [Conclusions] Hand-assisted laparoscopic resection is feasible and safe for selected patients. It is worth selecting minimally invasive method to benefit from reducing operative diitlculty and shortening operative time and applying immediate hemostasis.