腹腔镜肝部分切除治疗肝血管瘤25例临床分析

Clinical Analysis of Laparoscopic Partial Hepatectomy in Treatment of Hepatic Hemangioma:a Report of 25 Cases

目的探讨腹腔镜肝切除术治疗肝血管瘤的可行性及疗效分析。方法对2005年7月-2009年12月在永州市人民医院行腹腔镜肝部分切除术治疗肝血管瘤25例进行可行性及疗效分析。结果 25例中2例中转开腹,23例完成腹腔镜肝部分切除,腹腔镜肝部分切除手术时间40～300min,平均190min,术中出血量约200～1500ml,平均450ml,全组无手术死亡,一例出现胆漏,保守治疗治愈,平均住院8d。结论对位于肝脏边缘,右肝表面或左肝外叶,左半肝,肝右前叶下段的血管瘤,行腹腔镜肝切除具有手术并发症少、术后恢复快等优点。

Objective To explore the feasibility and therapeutic effect of laparoscopic partial hepatectomy （LPH） in the treatment of hepatic hemangiomas.Methods The therapeutic effects of 25 patients who underwent LPH for hepatic hemangiomas from July,2005 to December,2009 were evaluated and analyzed.Results Twenty-five patients underwent LPH,but 2 patients required conversion to open hepatectomy because of excessive bleeding.23 patients successfully underwent LPH.The average time of LPH was 190 min （ranging from 40～300 min）.The mean intraoperative blood loss was 450 ml （ranging from 200～1500 ml）,and the mean hospital stay was 8 days.No patients died during the operation.Bile leakage occurred in one patient,who recovered soon through conservative treatment.Conclusions LPH is suitable for hemangiomas located in the edge of livers,right surface or lower segment of right anterior leaf,left lateral lobe or left lateral segment.It has the advantages of fewer complications and rapid recovery.