螺旋水刀在解剖性肝切除术中的应用

Application of helix hydro-jet in anatomical liver resection

目的探讨螺旋水刀在解剖性肝切除术中的应用价值。方法对广东医学院附属医院2003年9月至2006年6月所实施的97例螺旋水刀解剖性肝切除病人的手术资料进行回顾性分析。结果97例手术中有89例不需阻断肝门，断肝时间为15～45min，断面处理时间为8～20min，出血量在150～1200ml之间（〈800ml 93例，〉800ml4例）；术中视野清晰，肝内管道系统暴露充分，未发生管道系统误损，术后B超监测未发现有重要血管损伤的表现；围手术期无死亡病例；术后肝功能恢复时间平均约为1周。结论螺旋水刀解剖性肝切除术的应用是安全、可行的，能减少肝门血流阻断，减少术中出血量，缩短术后肝功能恢复时间。

Objective To evaluate the feasibility and value of helix hydro-jet in anatomical liver resection. Method The clinical data of 97 patients receiving anatomical liver resection using helix hydro-jet in our hospital from September 2003 to June 2006 were retrospectively analyzed. Results Eighty-nine of 97 the patients underwent interdict portal triad clamping. The liver resection duration was 15--45 min. The disposal time of break-surface was 8--20 min. The intraoperative bleeding was 150--1200 ml （〈800 ml in 93 cases and 〉800 ml in 4）. There was clear field during operation. The intrahepatie biliary tracts were completely exposed. There was no wrongly injured hepatic canal system. The postoperative monitoring by B-mode ultrasonography showed that no important blood vessels were damaged. There was no death during the perioperative period. All the patients recovered about t week after conservative therapy. Conclusion Application of helix hydro-jet in anatomical liver resection is safe and feasible and can reduce portal triad clamping and bleeding volume. Meanwhile, it can shorten the average time of the recovery of liver function.