单孔腹腔镜BISMUTHⅠ型肝门胆管癌切除术二例:附视频

Single-incision laparoscopic resection of Bismuth Ⅰ hilar cholangiocarcinoma: one report of two cases

目的探讨单孔腹腔镜行BISMUTH Ⅰ型肝门胆管癌切除的安全性和可行性。方法回顾性总结和分析2例行经脐单孔腹腔镜BISMUTHⅠ型肝门胆管癌切除患者的术前、术中和术后情况。结果 2例患者均成功完成手术,手术时间分别为300min和350min;术中出血量为200ml和350ml;术后住院日分别为6d和9d。术后病理切除标本切缘肿瘤细胞阴性。1例术后出现胆汁漏,持续6d后闭合。患者对切口满意度高。结论在严格选择患者的基础上,单孔腹腔镜BISMUTHⅠ型肝门胆管癌切除术是安全和可行的,需要进一步的临床、随机、对照试验评价其临床应用价值。

Objective：To investigate the safety and feasibility of single-incision laparoscopic resection of Bismuth I hilar cholangiocarcinoma. Methods：Two cases with Bismuth I cholangiocarcinoma were chosen for the laparoscopic surgery. Segmental bile duct resection and hepatoduodenal ligament lymphadenectomy were performed using single-incision laparoscopic technique with conventional instruments. Results：Two operations were successfully performed without conversion. The operation time was 300 and 350 minutes, respectively. The margins of proximal and distal bile ducts were negative. The hospital stay was 6 and 9 days, respectively. The abdominal wound recovered very well with good cosmesis. Conclusions：Single-incision laparoscopic surgery cholangiocarcinoma resection can be optional in strictly selected patients with Bismuth I cholangiocarcinoma. Long-term follow-up and more data are needed to evaluate its benefits.