腹腔镜肝左外叶切除规范化手术方案的探讨

An exploration to the standard operation plan of laparoscopic hepatic left lateral lobectomy

目的探讨完全腹腔镜肝左外叶切除的手术方案,制定相对安全、速度更快的规范化手术方案。方法回顾性分析2008年1月至2010年10月48例行完全腹腔镜肝左外叶切除术患者的临床资料,所有患者断肝前均未常规进行左肝静脉的游离阻断,均采用内镜切割闭合器处理肝蒂。结果 48例患者均成功完成手术。术后住院时间为3～9d。2例患者发生胆漏,引流5d后痊愈,未发生腹腔内感染、大出血等并发症,无死亡病例。结论内镜切割闭合器进行肝左外叶切除简便、易行,有望成为腹腔镜肝左外叶切除的规范化手术方案。

Objective Explore the operation plan of laparoscopic hepatic left lateral lobectomy, to formulate a safer and faster operation plan. Methods Retrospectively analyzed the clinical data of laparoscopic hepatic left lateral lobectomy on 48 cases from January 2008 to October 2010. All patients didn＇t block up the left hepatic veins and used the Endo-GIA to cut off the hepatic pedicle. Results All of 48 patients were successfully performed operation of laparoscopic hepatic left lateral lobectomy. The patients were discharged 3-9 days after the operation. Biliary fistula ccurred in 2 cases after the operation, which were cured by drainage for 5 days. There was no patient dead. Conclusions Use the Endo-GIA to cut off the hepatic pediele is safe and feasible to the lraparoscopie hepatic left lateral lobectomy.