腹腔镜肝切除30例临床分析

Laparoscopic liver resection：report of 30 cases

目的探讨腹腔镜肝切除手术相关技术问题。方法2002年7月至2011年12月行腹腔镜肝切除术30例，其中肝细胞肝癌10例，海绵状血管瘤11例，局灶性结节性增生2例，直肠癌肝转移2例，另5例为其他肝脏占位性病变。病灶最大径2～12cm，平均（5．8±3．0）cm。结果30例中29例顺利完成完全腹腔镜肝切除手术，1例中转开腹。腹腔镜手术时间（180．1±50．2）m．n，术中出血量（257．0±180．3）ml。引流管留置2～4d。30例均未出现与手术相关的胆漏、出血等并发症。病人术后住院（6．7±2．3）d。结论在合理选择手术适应证的前提下，腹腔镜肝切除术安全、可行。

Objective To investigate the operative techniques in laparoscopic liver resection. Methods The clinical data of 30 patients undergoing laparoscopic liver resection from July 2002 to De- cember 2011 were analyzed. The patients included 11 cases of liver hemangioma, 10 cases of primary liver cancer, 2 cases of rectal carcinoma liver metastases, 2 cases of focal nodular hyperplasia and 1 case for each one of cholangiocarcinoma, intrahepatic biliary cystadenoma, hepatic adenoma, liver ab- scess and liver cyst infection. The diameter of the focus lies between 2 and 12 cm, averagely （5.8± 3.0） cm. Results Laparoscopic liver resection was completed under pneumoperitoneum in 29 cases, and one case was converted to traditional open-operation. The operating time was （180. 1 ＋ 50. 2） min and the blood loss was （257. 0 ＋ 180. 3） ml. No intraoperative blood transfusion was required in 27 ca- ses. The abdominal drains were left for 2-4 days and no bile leakage, bleeding or other complications happened. The postoperative hospital stay in patients with laparoscopic hepatectomy was averagely （6. 7 ± 2. 3） days. Conclusion Properly choosing indications is the key to the laparoscopic liver resection. Laparoseopic hepatectomy is feasible and safe for liver resection.