完全腹腔镜下肝左叶切除的临床观察

Clinical observation of laparoscopic hepatectomy on left liver resection completely

目的探讨完全腹腔镜下肝左叶切除(laparoscopic hepatectomy,LH)的临床效果。方法回顾性分析2011年1月～2011年12月10例行腹腔镜肝左叶切除患者的临床资料,与同期15例开腹行肝左叶切除(open hepatectomy,OH)患者的临床资料相比较,比较两组患者的手术时间、术中出血量、切口长度、留置引流管时间、术后进食时间、术后住院天数、有无手术并发症以及术前术后肝功能变化等指标。结果所有手术均成功完成,LH组切口长度、留置引流管时间、术后进食时间、总住院时间、术后谷丙转氨酶、谷草转氨酶、胆红素水平等方面与OH组比较具有明显的优势,差异有统计学意义(P<0.05)。在手术时间、术中出血量、术后并发症上两组间差异无统计学意义(P>0.05)。结论完全腹腔镜下肝左叶切除具有安全、有效、微创特点,可作为肝左叶切除的金标准。

Objective To explore the clinical effect of laparoscopic hepatectomy （LH） on left liver resection completely. Methods Retrospective analyzed of clinical material about 10 cases of laparoscopic hepatectomy （LH） on left liver resection from January 2011 to December 2011, compared with 15 cases of open left hepatic resection （open hepateetomy, OH） patients on operation time, perioperative bleeding, incision length, lien drainage tube feeding time, postoperative meal time, postoperative hospitalization days, complications, preoperatie and postoperative liver function change and other indicators. Results All LH performed successfully, LH group＇s incision length, lien drainage tube feeding time, postoperative meal time, total length of hospital stay, postoperative cereal third transaminase, aspertate aminotransferase, bilirubin level and so on had the obvious advantage compared with the OH, the difference was statistically significant （P 〈 0.05）. In the operation time, peri-operative bleeding and complications, there was no statistical significance with the difference between the two groups （P 〉 0.05）. Conclusion Laparoscopic hepatectomy （LH） on left liver resection completely is safe, effective and minimally invasive features, and can be used for the gold standard of left liver resection.