腹腔镜肝切除应用体会

Experience in laparoscopic liver resection

目的探讨腹腔镜在肝脏手术中应用的可行性。方法8例原发性肝癌，9例肝海绵状血管瘤，3例肝局限性增生结节，4例肝内胆管结石，1例肝脂肪瘤，1例肝脏多发性肉芽肿。在全气腹状态下行肝叶、段切除术。结果所有病例均获得成功，无中转开放手术。手术时间60-240min，平均120min。术中出血50-800ml，平均490ml。术后恢复顺利，无胆漏、出血等并发症，住院时间为3～15d，平均9d。随访3～24个月，平均18个月，肝内胆管结石病人手术后1个月胆道镜检查，无结石残留，肝癌病人1例手术后6个月复发，手术后10个月死亡。结论应用腹腔镜进行肝脏手术是安全、有效、不需输血或少输血，且创伤小、恢复快、住院时间短，可有效减少并发症。

Objective To study the feasibility of laparoscopy in liver surgery. Methods The liver was resected with laparoscopy in 8 patients with hepatic carcinoma, 9 with liver spongy hemangioma, 3 with local hyperplastic node, 4 with hepatolithiasis, 1 with liver lipoma and 1 with liver multigranuloma. Results The operation was successfully performed in all the 26 patients. The operative duration was 60-240 min （mean=120 min） and blood loss 50-800 ml （mean=490 ml）. The post operative recovery was smooth and good. The hospitalization duration was 3-15 d （mean=9 d）. No severe complications occurred. One patient with hepatic carcinoma had recurrence 6 months and died 10 months after the operation. Conclusions Laparoscopy is safe, effective, minimally invasive for liver surgery. Meanwhile, postoperative complications can be decreased by using the technique.