腹腔镜手术治疗肝良性肿瘤18例体会

Experience in treating 18 cases of laparoscopic liver benign tumor

目的:探讨腹腔镜肝良性肿瘤切除术的可行性。方法:回顾分析2013年9月至2015年5月完成的腹腔镜及开放肝良性肿瘤切除手术各18例患者的临床资料,对比分析两组患者手术时间、术中出血量、术后住院时间及出血、胆漏等并发症发生情况。结果:腹腔镜组手术时间平均(120.79±54.24)min,术中出血量平均(250.89±52.71)ml,术后平均住院(6.32±2.61)d,术后第1天引流量平均(200.89±52.71)ml;开放手术组手术时间平均(151.29±60.67)min,术中出血量平均(376.84±32.06)ml,术后平均住院(11.78±2.53)min,术后第1天引流量平均(176.84±32.06)ml。两组患者均未发生胆漏、出血、感染等并发症。两组手术时间、术中出血量、术后住院时间、术后第1天引流量差异有统计学意义。结论:腹腔镜肝良性肿瘤切除术安全、可行。与传统开放手术相比,腹腔镜肝良性肿瘤切除术手术时间短,出血量相对较少,患者术后康复快,术后并发症发生率两种术式无明显差异。

Objective： To explore the feasibility of laparoscopic resection of benign liver tumor. Methods： The clinical data of18 laparoscopic surgeries and 18 traditional laparotomies for benign liver tumor resection from Sep. 2013 to May 2015 were retrospectively analyzed. The operation time,intraoperative blood loss,postoperative hospital stay,postoperative bleeding,bile leakage and other complications were compared and analyzed. Results： The average operation time of laparoscopic group was（ 120. 79 ± 54. 24） min,the average amount of bleeding was（ 250. 89 ± 52. 71） ml,postoperative hospitalization time was（ 6. 32 ± 2. 61） d,drainage of first day after operation was（ 200. 89 ± 52. 71） ml. In open operation group,operation time was（ 151. 29 ± 60. 67） min,the amount of bleeding was（ 376. 84 ± 32. 06） ml,postoperative hospitalization time was（ 11. 78 ± 2. 53） min,drainage of first day after operation was（ 176. 84 ± 32. 06） ml. Bile leakage,bleeding,infection or other complications were not found in all cases. Between two groups,operation time,intra-operative bleeding volume,postoperative hospitalization time,drainage of first day after operation were significantly different. Conclusions： With regard to the resection of benign liver tumors,laparoscopic surgeries have advantages over traditional laparotomies in shorter operation time,less intraoperative bleeding and faster postoperative recovery. No significant difference of the complication rate is found between the two surgical methods. Laparoscopic resection of benign liver tumor is safe and feasible.