腹腔镜解剖性肝叶切除术治疗肝良恶性病变

Laparoscopic anatomical liver lobectomy for liver tumor

目的 探讨腹腔镜下解剖性肝叶切除术治疗肝良恶性病变的安全性、可行性。方法 对2005年1月至 2010年2月在我院行腹腔镜下解剖性肝部分切除术的67例患者进行可行性及疗效分析，并对其临床效果进行观察。结果 67例完全腹腔镜下解剖性肝叶切除术均获得成功，平均手术时间（50.6±16.2）min；术中平均出血量（220.8±76.5）ml。术中无需阻断肝门血流，术后无并发症发生。术后 48 h均能下床活动，术后 1～3 d即能进食。术后住院 5～7 d，平均（6.6±1.1）d；总住院费用（30767.4±150.1）元。结论 对位于肝左叶、右肝表面、肝右叶下段的良恶性病灶，行腹腔镜下解剖性肝叶切除术是安全和可行的，且具有创伤小恢复快的特点，值得临床推广应用。

Objective To study the feasibility and safety of laparoscopic anatomical liver lobectomy for liver tumor. Methods The feasibility and therapeutic effect of laparoscopic anatomical liver resection on 67 patients were analyzed in our hospital from January 2005 to February 2010. Results Laparoscopic anatomical liver lobectomy was carried out successfully on all the patients. The operative time was 50.6±16.2 min and the blood loss was 220.8±76.5 ml. We did not use Pringle′s manoeuvre. There was no postoperative complication. The patients were able to be ambulated out of bed within 24 hours and they started to take in food 1-3 days after surgery. The mean hospital stay was 5-7 days after surgery （mean 6.6±1.1 d）. The total hospital cost was 30767.4±150.1 Yuan. Conclusions Laparoscopic anatomical liver resection is feasible and safe. It has the advantages of minimal trauma and quick recovery for tumors located superficially, in the left liver, and in the inferior part of the right liver. Clinically, it should be used more widely.