Glisson蒂横断式腹腔镜肝切除术:附18例报告

Laparoscopic hepatectomy with Glissonean pedicle transection method: a report of 18 cases

目的：探讨Glisson蒂横断式在腹腔镜左半肝及肝左外叶切除术的可行性与安全性。方法：回顾性分析2011年1月—2013年6月期间18例行腹腔镜下Glisson蒂横断式肝切除术患者的临床资料。结果：18例患者均成功实施腹腔镜下Glisson蒂横断式左半肝或左外叶肝切除术,无中转开腹。手术时间为42~300 min,平均（215.6±56.6）min;术中出血量为50~200 mL,平均（118.6±50.5）mL,均未输血;住院时间为（8~16）d,平均（11.4±3.1）d,无并发症发生。所有患者随访3~24个月,生存情况均良好,其中6例肝细胞癌患者未见肿瘤复发。结论：Glisson蒂横断术能够有效控制出血,在腹腔镜解剖性左半肝或左外叶肝切除术中是安全可行的。

Objective： To investigate the feasibility and safety of Glissonean pedicle transection method for laparoscopic hepatectomy. Methods： The clinical data of 18 patients undergoing laparoscopic liver resection with Glissonean pedicle transection method between January 2011 and June 2013 were retrospectively analyzed. Results： All of the 18 patients successfully underwent laparoscopic left hemihepatectomy or left lateral lobectomy using Glissonean pedicle transection method, and without any open conversion. The operative time was 42-300 min with an average of （215.6±56.6） min, the intraoperative blood loss was 50-200 mL with an average of （118.6±50.5） mL and without a need for blood transfusion, the length of hospital stay was 8-16 d with an average of （11.4±3.1） d, and there was no occurrence or complications. The patients were followed-up for 3-24 months, all of them were alive and had a satisfactory quality of life, and no tumor recurrence occurred in the 6 cases with hepatocellular carcinoma. Conclusion： Glissonean pedicle transection method can effectively control bleeding, and the use of this method in laparoscopic anatomic left hemihepatectomy or left lateral lobectomy is safe and feasible.