腹腔镜肝切除术10例报告

Laparoscopic Hepatectomy:with a Report of 10 Cases

目的探讨腹腔镜肝切除术的安全性和可行性。方法回顾分析我院2007年1月至2009年12月独立完成的腹腔镜肝切除术10例,其中原发性肝癌4例,肝转移鳞癌(肺癌术后)1例,肝局灶性结节增生2例,肝海绵状血管瘤并胆囊结石1例,多囊肝1例,肝局灶性肝细胞脂肪变伴胆囊结石1例。肝功能Child-Pugh分级A级9例,B级1例。结果 10例均成功行腹腔镜肝切除术,无中转开腹。手术时间92～362分钟,平均(209±77.64)分钟,术中出血20～1800ml,平均(787±643.7)ml,无严重并发症。10例术后随访12～47个月,其中4例原发性肝癌患者中1例术后3个月复发,12个月后死亡。另3例均无瘤生存,最长1例成活39个月。结论腹腔镜肝切除术安全可行,其不但适用于良性肿瘤,也部分适用于恶性肿瘤。

Objective To evaluate the feasibility and safety of laparoscopic hepatectomy.Methods A total of 10 patients received operation by using laparoscopy from January 2007 to December 2009.There were four cases of primary hepatocellular carcinoma,one case of hepatic metastases from lung cancer,two cases of liver focal nodular hyperplasia,one case of liver cavernous hemangioma,one case of polycystic liver combined with cholecystolithiasis,and one case with fatty degeneration of liver combined with cholecystolithiasis.The liver function of all the patients was in Child-Pugh A（9 cases） to B（1 case）.Results All the 10 patients were undergone laparoscopic liver resection successfully,without conversion to open surgery.The average operation time was（209 ± 77.64） minutes,and the intraoperative average hemorrhage was（787 ± 643.7） ml.All the patients recovered well without severe complication.All the patients were followed-up for 12 to 47 months.Of the four liver cancer patients,one patient died of cancer recurrence at 12 months and the other three patients survived（the longest survival time was 39 months）.Conclusions Laparoscopic hepatectomy is safe and feasible for benign liver disease.It can also be applied in the treatment of malignant liver disease.