自制肝门阻断带在腹腔镜肝切除术中的应用体会

Application of the self-made band for portal triad clamping in laparoscopic hepatectomy

目的:总结自制肝门阻断带在腹腔镜肝脏手术中行肝门阻断的临床效果。方法:将60例肝切除术患者随机分为两组,A组(n=30)于腹腔镜下使用自制肝门阻断带阻断肝门后行肝部分切除术,B组(n=30)开腹肝门阻断后行肝切除术。对比两组术中出血量、手术时间、术后住院时间等。结果:两组手术均获成功,术后患者均康复出院。两组患者术中出血量、手术时间及肝门阻断时间差异无统计学意义(P>0.05);术后住院时间差异有统计学意义(P<0.05)。结论:腹腔镜肝切除术应根据病变位置、肿瘤大小、手术类型、肝硬化程度等因素综合考虑,术中应用自制肝门阻断带阻断入肝血流简单、实用、安全、有效,值得推广。

Objective ： To observe the result of the self-made band for portal triad clamping in laparoscopic hepatectomy. Meth- ods：Sixty patients who suffered from hepatoma and underwent hepatectomy were divided into two gronps：group A （n = 30） underwent laparoscopic hepatectomy with portal triad clamping by the band mentioned above ; group B （ n = 30） underwent open hepatectomy with conventional portal triad clamping. The following parameters were compared within the 2 groups：intra-operative blood loss （IOBL）, op- erative duration （ OD）, the time of hepatic portal triad clamping （ THC）, and post-operative hospital stay （POHS）. Results ： All opera- tions were successful. All patients recovered from the operations without any complications. There was no difference between the 2 groups in IOBL, OD or THC （ P 〉 0.05 ）. However, the POHS was shorter in group A （ P 〈 0.05 ）. Conclusions ： Laparoscopic hepatec- tomy should be chosen according to comprehensive factors,such as lesions location, size of tumor,operation style,the degree of hepatic： cirrhosis and so on. It is suggested that our self-made band for portal triad clamping is a simple, practical, safe and effective device in laparoscopic hepatectomy. This procedure should be generalized.